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COMMERCIAL GENERAL LIABILITY CG 26991204 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ALASKA WAR LIABILITY EXCLUSION This endorsement modifies insurance provided under the following LIQUOR LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY The War Exclusion is replaced by the following 2. Wa This insurance does not apply to 210 WAR SOV Injury or damage however caused arising out of sor 1. War including undeclared or civil war or 3. Ins 2. Warlike action by a military force including action in hindering or defending against an ac tual or expected attack by any government sovereign or other authority using military per sonnel or other agents or 3. Insurrection rebellion revolution usurped power or action taken by governmental author ity in hindering or defending against any of these. CG 26991204 ISO Properties Inc. 2003 MWZY 308156 NPC International Inc. 09302016 09302017 Page 1 of 1 | 2 |
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Contact Name East West Copolymer Rubber LLC 5955 Scenic Highway Baton Rouge LA 70805 pbenoitlockton.com IT7063 version date 01 2003 Page 1 of 1 | 2 |
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ace usa LOCKTON COMPANIES LLC 444 WEST 47TH STREET SUITE 900 KANSAS CITY MO 641121906 RE ACE USA Foreign C Routing 1 One Beay Wilmingto Insured Name East West Copolymer Rubber LLC Policy Number PHFD38338985 003 Policy Term 04162016 04162017 ACE USA Foreign Casualty Routing 1275 2W One Beaver Valley Road Wilmington DE 19803 1.800.204.0518 tel 302.476.6456 fax Dear Philip Enclosed is the Renewal policy for the above named insured. Thank you for the opportunity to provide a solution for the international insurance needs of East West Copolymer Rubber LLC. On behalf of ACE Foreign Casualty am pleased to present the attached International Advantage Package Policy with Executive Assistance Services. Included with this letter and the Policy are the following documents to be shared with the Policyholder Premium Payments Procedures Claim Reporting Procedures ACE USA s Privacy position required by law to be provided to Policyholders with each new business policy or each renewal term change Explanation of Executive Assistance Services and other proprietary information regarding the use of those Services. A benefit that complements the International Advantage Package Policy coverage plan Executive Assistance Services are designed to provide covered employees volunteers or students with pre trip security information as well as emergency assistance emergency medical and political evacuation or concierge services while they are traveling on covered trips worldwide. This information must be delivered to the contact at East West Copolymer Rubber LLC who is responsible for supplying covered services information. Advisory Notice to Policyholders on United States Office of Foreign Assets Control requirements regarding trade related sanctions against certain designated foreign countries and Specially Designated Nationals. This advisory is provided as a courtesy. Trade or Economic Sanctions are addressed in Our Common Policy Conditions. ACE USA with offices in 18 cities is the U.S.based retail operating division of the ACE Group of Companies a global leader in property and casualty insurance and reinsurance that serves a diverse group of clients. Rated A Superior by A.M. Best Company and AA Very Strong by Standard Poor s ACE conducts business on a worldwide basis in more than 140 countries. Our goal is to provide you and your client with continuous quality service. After reviewing your documents if further assistance is needed contact us at 1.800.204.0518. Contact information Underwriter KellyFrein Kelly.FreinACEGroup.com 302 476 6535 Multinational Account Specialist JANICE YOUNG K4F 2122016 IT7057 version date 03 2011 Page 1 of 1 | 2 |
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INTERNATIONAL ADVANTAGE COMMERCIAL INSURANCE POLICY K4F 2122016 IT7000 version date 05 2014 Page 1 of 2 | 2 |
GENERAL INFORMATION PAGE VI INTRODUCTION This is your Commercial Insurance Policy. It offers a wide range of protection designed to meet today s complex insurance needs. Various provisions in this policy restrict coverage. Read the entire policy carefully to determine rights duties and what is and is not covered. HOW TO READ THIS POLICY This policy is keyed to the coverages shown in the Declarations. You have only those coverages for which a limit or other specification is shown in the Declarations. This policy may provide several different kinds of coverage. The forms included explain the coverages shown in the Declarations and include certain extensions of coverage that may apply. The titles and headings to the various parts sections subsections and endorsements of this policy are included solely for ease of reference and do not in any way limit expand or otherwise affect the provisions of such parts sections subsections or endorsements. The singular of a term includes the plural and vice versa. Whenever a loss occurs or a claim is to be presented there are certain things you must do to help us settle the claim. These are described in the CONDITIONS sections of your policy. Finally read the COMMON POLICY CONDITIONS. This section gives you information on when and where the policy will be in effect the payment of premiums changes in the policy and cancellation. The COMMON POLICY CONDITIONS also contains other important information about the policy. YOU AND YOUR Throughout the policy the terms you and your mean the person people or organization shown as the Named Insured in the Declarations. Besides you there may be other people insured under certain parts of the policy.. WE US AND OUR Throughout the policy the terms we us and our mean the insurance company issuing this policy. INSURED The word insured means any person or organization qualifying as such under the WHO IS AN INSURED sections of the coverage form in which they appear. WORDS IN QUOTATION MARKS Words and phrases that appear in quotation marks have the special meaning given to them in the DEFINITIONS sections of the coverage form in which they appear. By signing and delivering the policy to you we state that it is a valid contract when counter signed by our authorized representative. ACE AMERICAN INSURANCE COMPANY JOHN J. LUPICA. President A ol REBECCA L. COLLINS Secretary K4F 2122016 IT7000 version date 05 2014 Page 2 of 2 | 2 |
GENERAL DECLARATIONS INTERNATIONAL ADVANTAGE COMMERCIAL INSURANCE POLICY POLICY SYMBOL AND NUMBER COMPANY NAME PHF D38338985 003 ACE AMERICAN INSURANCE COMPANY Renewed or in place of PHF D38338985 002 COMPANY NAME ACE AMERICAN INSURANCE COMPANY NAMED INSURED AND MAILING ADDRESS East West Copolymer Rubber LLC 5955 Scenic Highway Baton Rouge LA 70805 NAMED INSURED IS LLC POLICY PERIOD When Coverage Begins 04162016 When Coverage Ends 04162017 1201 A.M. Standard Time at your me POLICY PERIOD When Coverage Begins 04162016 When Coverage Ends 04162017 1201 A.M. Standard Time at your mailing address shown above CURRENCY U.S. DOLLARS PREMIUM 2500 Due When Coverage Begins In return for the payment of premium indicated above we agree with you to provide insurance in accordance with the terms and conditions of this policy. If the Coverage Declarations indicate that this insurance is subject to audit or if there is a reporting condition endorsement the premium stated is an estimate and subject to adjustment. These Declarations apply for the policy period shown above. Together with the policy sections for Coverage Common Policy Conditions and Endorsements these Declarations complete your policy. For renewal policy periods all Coverage Forms and Endorsements for the expiring policy period are continued in full force and effect unless specifically deleted. PRODUCER Philip Benoit Code Office 115579 NAME AND MAILING ADDRESS LOCKTON COMPANIES LLC 444 WEST 47TH STREET SUITE 900 KANSAS CITY MO 641121906 pbenoitlockton.com nan nan nan nan 6.0 K4F 2122016 IT7001 version 08 2010 Page 1 of 1 | 2 |
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LIABILITY COVERAGES DECLARATIONS ACE AMERICAN INSURANCE COMPANY NAMED INSURED East West Copolymer Rubber LLC and address 5955 Scenic Highway Baton Rouge LA 70805 POLICY NUMBER PHFD38338985 003 POLICY PERIOD 04162016 to 04162017 at 1201 Standard Time at the address shown above COVERAGES LIMITS OF INSURANCE Insurance applies only to those coverages for which a Limit of Insurance is shown COMMERCIAL GENERAL LIABILITY COVERAGE FORM 1000000 Each Occurrence NOT APPLICABLE General Aggregate Not Covered Products Completed Operations Aggregate 1000000 Personal and Advertising Injury Limit any one person or organization 1000000 Damage To Premises Rented to You Limit any one premises 25000 Medical Expenses Limit any one person EMPLOYEE BENEFITS LIABILITY COVERAGE FORM 1000000 Each Claim 1000000 Annual Aggregate Limit CONTINGENT AUTO LIABILITY COVERAGE FORM 1000000 Each Accident PREMIUM AUDIT APPLIES. PREMIUM AUDIT DOES NOT APPLY. COVERAGE TERRITORY FOR LIABILITY COVERAGES bl s 2nic Highway uge 985003 POLICY PERIOD 04162016 to 04162017 e b e A b d address IT7003 version date 04 2015 Page 1 of 2 K4F 2122016 | 2 |
The Coverage Territory for COMMERCIAL GENERAL LIABILITY COVERAGE EMPLOYEE BENEFITS COVERAGE and CONTINGENT AUTO LIABILITY COVERAGE means ANYWHERE IN THE WORLD but excluding the United States of America including its territories and possessions Puerto Rico and Canada and except as otherwise limited or extended by this insurance. In jurisdictions where we may be prevented by law or otherwise from paying on behalf of or defending the insured we will 1. indemnify the insured for those sums that the insured becomes legally obligated to pay as damages to which the insurance applies and 2. pay the cost of defense and aid and manage the insured s defense. IT7003 version date 04 2015 Page 2 of 2 K4F 2122016 | 2 |
Named Insured East West Copolymer Rubber LLC Policy Number PHFD38338985 003 Declarations Effective 04162016 Company Name ACE American Insurance Company EMPLOYERS RESPONSIBILITY COVERAGES DECLARATIONS I.BENEFITS FOR VOLUNTARY COMPENSATION North Americans State of Hire Third Country Nationals Country of Origin Local Nationals Employers Liability Only Il. EXECUTIVE ASSISTANCE SERVICES 1000000 policy limit for Medical Assistance Services Ill. EMPLOYERS LIABILITY Bodily Injury by Accident 1000000 each accident Bodily Injury by Disease including by endemic disease 1000000 each employee Bodily Injury by Disease including by endemic disease 1000000 policy limit In jurisdictions where we may be prevented by law or otherwise from paying on your behalf or defending you we will 1. indemnify you for those sums you become legally obligated to pay as damages to which this insurance applies and 2. pay the cost of your defense and aid and manage such defense. Coverage Territory for Employers Responsibility Coverages This insurance applies 1. to claims you make for voluntary compensation and repatriation for employees of your workplaces included below 2. to claims or suits for damages for employers liability brought against you by employees of your workplaces included below 3. to assistance rendered to employees of your workplaces included below when traveling 100 miles or more from home and to expatriate employees without limitation of travel distance ANYWHERE IN THE WORLD but excluding 1. the United States of America including its territories and possessions Puerto Rico and Canada and except as otherwise limited or extended by this insurance. 2. any country or jurisdiction which is the subject of trade or economic sanctions imposed by the laws or regulations of the United States of America. K4F 2122016 IT1X70 version date 04 2015 Page 1 of 1 | 2 |
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aceusa ACCIDENTAL DEATH AND DISMEMBERMENT AND MEDICAL EXPENSE DECLARATIONS ACE AMERICAN INSURANCE COMPANY NAMED INSURE POLICY NUMBE ast West Copolymer Rubber LLC HFD38338985 003EFFECTIVE DATE 04162016 Insurance applies only to those coverages for which a Principal Sum is shown. Regardless of the number of accidents occurrences covered persons or claims the company shall not be liable for any amount in excess of the applicable aggregate limit of liability set out below. If in the absence of this provision the company would pay more than the amount of such aggregate limit for a particular coverage then the benefits payable to each covered person with a valid claim for such coverage will be reduced proportionately so that the total amount the company will pay for such coverage is no greater than the applicable aggregate limit. Accidental Death and Dismemberment and Medical Coverage Non Occupational Coverage A Accidental Death and Dismemberment Principal Sum Not Covered Spouse Not Covered Child Not Covered Coverage B Medical Expense Principal Sum 25000 Spouse Not Covered Child Not Covered Aggregate Limit of Liability 1500000 Accidental Death and Dismemberment and Medical Coverages including Occupational injury Coverage A Accidental Death and Dismemberment Principal Sum Not Covered Spouse Child Coverage B Medical Expense Principal Sum Not Covered Spouse Child Aggregate Limit of Liability Not Covered K4F 2122016 IT7009 version date 11 2010 Page 1 of 2 | 2 |
Accidental Death and Dismemberment and Medical Coverage for Educational Services Coverage A Accidental Death and Dismemberment Principal Sum Not Covered Coverage B Medical Expense Principal Sum Not Covered Aggregate Limit of Liability 2000000 K4F 2122016 IT7009 version date 11 2010 Page 2 of 2 | 2 |
aceusa CORPORATE KIDNAP AND EXTORTION DECLARATIONS ACE AMERICAN INSURANCE COMPANY NAMED INSURED East West Copolymer Rubber LLC POLICY NUMBER PHFD38338985 003 EFFECTIVE DATE 04162016 Insurance Applies only to those coverages for which a Limit of Insurance is shown. 250000 250000 250000 250000 10000 100000 250000 Territory Limits Each Covered Loss No Annual Aggregate Each Covered Loss No Annual Aggregate Each Covered Loss No Annual Aggregate Each Covered Loss No Annual Aggregate Sub limit Each Life Sub limit Each Incident Each Covered Loss No Annual Aggregate Worldwide but excluding the following countries Causes of Loss Extortion Ransom Monies Payment In Transit Extortion Ransom Monies Loss Expenses Legal Costs Medical Death or Dismemberment Medical Death or Dismemberment Incident Response Afghanistan Algeria Angola Brazil Chad Chechnya Colombia Cuba Democratic Republic of Congo Georgia Haiti Indonesia Iran Iraq North Korea Liberia Libya Mali Mauritania Mexico Nepal Niger Nigeria Pakistan Peru Philippines Saudi Arabia Sri Lanka East Timor Sierra Leone Somalia South Sudan Sudan Syria Trinidad Tobago Venezuela Yemen Zimbabwe IT7006 version date 12 2011 Page 1 of 1 K4F 2122016 | 2 |
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COMMON POLICY CONDITIONS All coverages of this policy are subject to the following conditions. 1. Bankruptcy and Insolvency Bankruptcy or insolvency of the insured or of the insured s estate will not relieve us of our obligations under this policy. Cancellation a. The first Named Insured shown in the Declarations first Named Insured may cancel this policy by mailing or delivering to us advance written notice of cancellation. b. We may cancel this policy by mailing or delivering to the first Named Insured written notice of cancellation at least 1 10 days before the effective date of cancellation if we cancel for nonpayment of premium. 2 90 days before the effective date of cancellation if we cancel for any other reason. c. We will mail or deliver our notice to the first Named Insured s last mailing address known to us. d. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date. e. If we cancel this policy we will send the first Named Insured any premium refund due. The refund will be pro rata. The cancellation will be effective even if we have not made or offered a refund. f. If the first Named Insured cancels this policy we will send the first Named Insured any premium refund due. The refund may be less than pro rata and will be calculated using the customary standard short rate scale or the cancellation tables promulgated under the laws of the state shown in the first Named Insured s mailing address on the Declarations whichever is more beneficial to the first Named Insured. The cancellation will be effective even if we have not made or offered a refund. g. If notice is mailed proof of mailing will be sufficient proof of notice. Changes This policy including all endorsements hereto contains all the agreements between you and us concerning the insurance afforded. This policy s terms can be amended or waived only by endorsement issued by us and made a part of this policy. Concealment Misrepresentation Or Fraud This policy is void in any case of fraud by you as it relates to this policy at any time. It is also void if you or any other insured at any time intentionally conceal or misrepresent a material fact concerning 1 This policy 2 The Covered Property or Covered Auto 3 Your interest in the Covered Property or Covered Auto or IT7029 version date 04 2010 Page 1 of 4 Material reprinted in part with permission of ISO Properties Inc. K4F 2122016 | 2 |
4 A claim under this policy. 5. Currency The currency which applies to insurances under this policy is stated in the Declarations. If a loss recoverable under this policy is agreed in another currency conversion will be at the free rate of exchange on the date of payment. The actual cost of repair or replacement which is not incurred until after the date of agreement will be settled at the time the actual costs are incurred. 6. Examination Of Your Books And Records We may examine and audit your books and records as they relate to this policy at any time during the policy period and up to three years afterward. 7. Inspections And Surveys We have the right but are not obligated to a. Make inspections and surveys at any time b. Give you reports on the conditions we find and c. Recommend changes. Any inspections surveys reports or recommendations relate only to insurability and the premiums to be charged. We do not make safety inspections. We do not undertake to perform the duty of any person or organization to provide for the health or safety of workers or the public. And we do not warrant that conditions a. Are safe or healthful or b. Comply with laws regulations codes or standards. This condition applies not only to us but also to any rating advisory rate service or similar organization which makes insurance inspections surveys reports or recommendations. 8. Insurance Under Two Or More Coverages If two or more of this policy s coverages apply to the same loss or damage we will not pay more than the actual amount of the loss or damage. 9. Liberalization If we revise or replace a Coverage Form that is part of this policy during the policy period to provide more coverage without an additional premium charge that Coverage Form will automatically provide the additional coverage as of the day that we adopt the revision. 10. Premiums a. The first Named Insured shown in the Declarations 1 Is responsible for the payment of all premiums and 2 Will be the payee for any return premiums we pay. b. The premium shown in the Declarations was computed based on rates in effect at the time the policy was issued. On each renewal continuation or anniversary of the effective date of this policy we will compute the premium in accordance with our rates and rules then in effect. IT7029 version date 04 2010 Page 2 of 4 Material reprinted in part with permission of ISO Properties Inc. K4F 2122016 | 2 |
With our consent you may continue this policy in force by paying a continuation premium for each successive one year period. The premium must be 1 Paid in accordance with our payment terms 2 Determined in accordance with Paragraph b. above. Our forms then in effect will apply. If you do not pay the continuation premium this policy will expire on the first anniversary date that we have not received the premium. Undeclared exposures or change in your business operation acquisition or use of locations may occur during the policy period that are not shown in the Declarations. If so we may require an additional premium. That premium will be determined in accordance with our rates and rules then in effect. 11. Premium Audit a. If this policy is subject to audit as designated on the Declarations then the premium shown on the Declarations is an advance premium. We will compute the final premium due when we determine your actual exposures. Premium shown in this policy as advance premium is a deposit premium only. At the close of each audit period we will compute the earned premium for that period. Audit premiums are due and payable on notice to the first Named Insured. If the sum of the advance and audit premiums paid for the policy period is greater than the earned premium we will return the excess to the first Named Insured. The first Named Insured must keep records of the information we need for premium computation and send us copies at such times as we may request. If the first Named Insured does not provide us with all requested information within the time required by us we will estimate the auditable exposure and calculate the audit premium based on such exposure. 12. Sole Agent If more than one person or organization is insured under this policy the first one named in the Declarations first Named Insured will act on behalf of all others. 13. Transfer Of Rights Of Recovery Against Others To Us a. Applicable to Property Coverage If any person or organization to or for whom we make payment under this policy has rights to recover damages from another those rights are transferred to us to the extent of our payment. That person or organization must do everything necessary to secure our rights and must do nothing after loss to impair them. But you may waive your rights against another party in writing 1 Prior to a loss to your Covered Property. 2 After aloss to your Covered Property only if at time of loss that party is one of the following a Someone insured by this insurance b Abusiness firm IT7029 version date 04 2010 Page 3 of 4 Material reprinted in part with permission of ISO Properties Inc. K4F 2122016 | 2 |
14. 15. 16. 17. 18. i Owned or controlled by you or i That owns or controls you or c Your tenant. You may also accept the usual bills of lading or shipping receipts limiting the liability of carriers. This will not restrict your insurance. b. Applicable to Liability Coverages If the insured has rights to recover all or part of any payment we have made under this policy those rights are transferred to us. The insured must do nothing after loss to impair them. At our request the insured will bring suit or transfer those rights to us and help us enforce them. This condition does not apply to Medical Expenses Coverage. Transfer Of Your Rights And Duties Under This Policy Your rights and duties under this policy may not be transferred without our written consent except in the case of death of an individual Named Insured. If you die your rights and duties will be transferred to your legal representative but only while acting within the scope of duties as your legal representative. Until your legal representative is appointed anyone having proper temporary custody of your property will have your rights and duties but only with respect to that property. Unintentional Errors or Omissions Your unintentional failure or omission to disclose all hazards existing as of the inception date of this policy shall not prejudice coverage afforded by this policy. When We Do Not Renew If we decide not to renew this policy we will mail or deliver to the first Named Insured shown in the Declarations written notice of the nonrenewal not less than 90 days before the expiration date. If notice is mailed proof of mailing will be sufficient proof of notice. When Your Coverage Begins Your coverage under this policy will begin and end at 1201 a.m. standard time at the address of the Named Insured and on the dates shown in the Declarations. However if this policy replaces other coverage that ends on the same day this policy begins this policy will not take effect until the other coverage ends. Trade or Economic Sanctions or Other Laws This insurance does not apply to the extent that trade or economic sanctions or other laws or regulations prohibit us from providing insurance including but not limited to the payment of claims. IT7029 version date 04 2010 Page 4 of 4 Material reprinted in part with permission of ISO Properties Inc. K4F 2122016 | 2 |
aceusa COMMERCIAL GENERAL LIABILITY COVERAGE FORM SECTION COVERAGES COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY 1. Insuring Agreement a. Payment 1 We will pay those sums that the insured becomes legally obligated to pay as damages because of bodily injury or property damage to which this insurance applies. 2 The amount we will pay as damages under subparagraph a.1 is limited as described in SECTION Ill LIMITS OF INSURANCE. Defense Investigation or Settlement 1 We will have the right and duty to defend the insured against any suit seeking damages for bodily injury or property damage. We have the right to settle any such suit. However we will have no duty to defend the insured against any suit seeking damages for bodily injury or property damage to which this insurance does not apply. 2 We may at our discretion investigate any occurrence and settle any claim or suit that may result. 3 Our right and duty to defend under subparagraph b.1 ends when we have used up the applicable Limit of Insurance in the payment of judgments or settlements under Coverages A or B or medical expenses under Coverage C. No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under Supplementary Payments Coverages A and B. How This Insurance Applies 1 This insurance applies to bodily injury and property damage only if a The bodily injury or property damage is caused by an occurrence that takes place in the coverage territory b The bodily injury or property damage occurs during the policy period and c Prior to the policy period no insured listed under paragraph 1. of SECTION Il WHO IS AN INSURED or any employee authorized by you to give or receive notice of an occurrence or claim knew or reasonably could have known that i. the bodily injury or property damage actually or allegedly sustained by the persons or organizations making the claim or bringing the suit had occurred in whole or in part or ii. any bodily injury or property damage arising out of the same occurrence had actually or allegedly been sustained by any other persons or organizations. K4F 2122016 IT7025 version date 07 2014 Page 1 of 27 Includes material reprinted with permission of ISO Properties Inc. | 0 |
Any continuation change or resumption of such bodily injury or property damage known or reasonably knowable under the standards set forth in ci. or ii. above during or after the policy period will be deemed to have been known prior to the policy period. 2 Bodily injury or property damage which occurs during the policy period and was not prior to the policy period known to have occurred by any insured listed under paragraph 1. of SECTION Il WHO IS AN INSURED or any employee authorized by you to give or receive notice of an occurrence or claim includes any continuation change or resumption of that bodily injury or property damage after the end of the policy period. 3 Bodily injury or property damage will be deemed to have been known to have occurred at the earliest time when any insured listed under paragraph 1. of SECTION Il WHO IS AN INSURED or any employee authorized by you to give or receive notice of an occurrence or claim a Reports all or any part of the bodily injury or property damage to us or any other insurer b Receives a written or verbal demand or claim for damages because of the bodily injury or property damage or c Becomes aware by any other means that bodily injury or property damage has occurred or has begun to occur. 4 Damages because of bodily injury include damages claimed by any person or organization for care loss of services or death resulting at any time from the bodily injury. 2. Exclusions for Coverage A This insurance does not apply to a. Expected or Intended Injury Bodily injury or property damage expected or intended from the standpoint of the insured. This exclusion does not apply to bodily injury resulting from the use of reasonable force to protect persons or property. Contractual Liability Bodily injury or property damage for which the insured is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages 1 That the insured would have in the absence of the contract or agreement or 2 Assumed in a contract or agreement that is an insured contract provided the bodily injury or property damage occurs subsequent to the execution of the contract or agreement. Solely for the purposes of liability assumed in an insured contract reasonable attorney fees and necessary litigation expenses incurred by or for a party other than an insured are deemed to be damages because of bodily injury or property damage provided a Liability to such party for or for the cost of that party s defense has also been assumed in the same insured contract and b Such attorney fees and litigation expenses are for defense of that party against a civil or alternative dispute resolution proceeding in which damages to which this insurance applies are alleged. K4F 2122016 IT7025 version date 07 2014 Page 2 of 27 Includes material reprinted with permission of ISO Properties Inc. | 1 |
c. Liquor Liability Bodily injury or property damage for which any insured may be held liable by reason of 1 Causing or contributing to the intoxication of any person 2 The furnishing of alcoholic beverages to a person under the legal drinking age or under the influence of alcohol or 3 Any statute ordinance or regulation relating to the sale gift distribution or use of alcoholic beverages. This exclusion applies only if you are in the business of manufacturing distributing selling serving or furnishing alcoholic beverages. Workers Compensation Or Similar Law Any obligation of the insured under a workers compensation or similar law. Employer s Liability Bodily injury to 1 An employee of the insured arising out of and in the course of a Employment by the insured or b Performing duties related to the conduct of the insured s business or 2 The spouse child parent brother or sister of that employee as a consequence of paragraph 1 above. This exclusion applies 1 Whether the insured may be liable as an employer or in any other capacity and 2 To any obligation to share damages with or repay someone else who must pay damages because of the injury. This exclusion does not apply to liability assumed by the insured under an insured contract. Pollution 1 Bodily injury or property damage arising out of or in any way related to pollution however caused. 2 Any loss cost or expense arising out of any a Request demand order or statutory or regulatory requirement that any insured or others test for monitor clean up remove contain treat detoxify or neutralize or in any way respond to or assess the effects of pollution or b Claim or suit by or on behalf of a governmental authority for damages because of testing for monitoring cleaning up removing containing treating detoxifying or neutralizing or in any way responding to or assessing the effects of pollution. K4F 2122016 IT7025 version date 07 2014 Page 3 of 27 Includes material reprinted with permission of ISO Properties Inc. | 1 |
g. Aircraft Auto Watercraft Bodily injury or property damage arising out of the ownership maintenance use or entrustment to others of any aircraft auto or watercraft owned or operated by or rented or loaned to any insured. Use includes operation and loading and unloading. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision hiring employment training or monitoring of others by that insured if the occurrence which caused the bodily injury or property damage involved the ownership maintenance use or entrustment to others of any aircraft auto or watercraft that is owned or operated by or rented or loaned to any insured. This exclusion does not apply to 1 A watercraft while ashore on premises you own or rent 2 A watercraft you do not own that is a Less than 50 feet long and b Not being used to carry persons or property for a charge 3 Parking an auto on or on the ways next to premises you own or rent provided the auto is not owned by or rented or loaned to you or the insured 4 Liability assumed under any insured contract for the ownership maintenance or use of aircraft or watercraft or 5 Bodily injury or property damage arising out of a The operation of machinery or equipment that is attached to or part of a land vehicle that would qualify under the definition of mobile equipment if it were not subject to a compulsory or financial responsibility law or other motor vehicle insurance law in the state or country where it is licensed or principally garaged or b The operation of any of the machinery or equipment listed in paragraph f.2 or.3. of the definition of mobile equipment. h. Mobile Equipment Bodily injury or property damage arising out of 1 The transportation of mobile equipment by an auto owned or operated by or rented or loaned to any insured or 2 The use of mobile equipment in or while in practice for or while being prepared for any prearranged racing speed demolition or stunting activity. i. War Bodily injury or property damage however caused arising directly or indirectly out of 1 War including undeclared or civil war 2 Warlike action by a military force including action in hindering or defending against an actual or expected attack by any government sovereign or other authority using military personnel or other agents or 3 Insurrection rebellion revolution usurped power or action taken by governmental authority in hindering or defending against any of these. IT7025 version date 07 2014 Page 4 of 27 K4F 2122016 Includes material reprinted with permission of ISO Properties Inc. K4F 2122016 | 1 |
j Damage to Property Property damage to 1 Property you own rent or occupy including any costs or expenses incurred by you or any other person organization or entity for repair replacement enhancement restoration or maintenance of such property for any reason including prevention of injury to a person or damage to another s property 2 Premises you sell give away or abandon if the property damage arises out of any part of those premises 3 Property loaned to you 4 Personal property in the care custody or control of the insured 5 That particular part of real property on which you or any contractors or subcontractors working directly or indirectly on your behalf are performing operations if the property damage arises out of those operations or 6 That particular part of any property that must be restored repaired or replaced because your work was incorrectly performed on it. Paragraphs 1 3 and 4 of this exclusion do not apply to property damage other than damage by fire to premises including the contents of such premises rented to you for a period of 7 or fewer consecutive days. A separate Limit of Insurance applies to Damage to Premises Rented to You in SECTION IIl LIMITS OF INSURANCE. Paragraph 2 of this exclusion does not apply if the premises are your work and were never occupied rented or held for rental by you. Paragraphs 3 4 5 and 6 of this exclusion do not apply to liability assumed under a sidetrack agreement. Paragraph 6 of this exclusion does not apply to property damage included in the products completed operations hazard. k. Damage to Your Product Property damage to your product arising out of it or any part of it. I. Damage to Your Work Property damage to your work arising out of it or any part of it and included in the products completed operations hazard. This exclusion does not apply if the damaged work or the work out of which the damage arises was performed on your behalf by a subcontractor. m. Damage to Impaired Property or Property Not Physically Injured Property damage to impaired property or property that has not been physically injured arising out of 1 Adefect deficiency inadequacy or dangerous condition in your product or your work or 2 A delay or failure by you or anyone acting on your behalf to perform a contract or agreement in accordance with its terms. This exclusion does not apply to the loss of use of other property arising out of sudden and accidental physical injury to your product or your work after it has been put to its intended use. IT7025 version date 07 2014 Page 5 of 27 K4F 2122016 Includes material reprinted with permission of ISO Properties Inc. | 1 |
n. Recall of Products Work or Impaired Property Damages claimed for any loss cost or expense incurred by you or others for the loss of use withdrawal recall inspection repair replacement adjustment removal or disposal of 1 Your product 2 Your work or 3 Impaired property if such product work or property is withdrawn or recalled from the market or from use by any person or organization because of a known or suspected defect deficiency inadequacy or dangerous condition in it. 0. Personal and Advertising injury Bodily injury arising out of personal and advertising injury. p. Electronic Data Damages arising out of the loss of loss of use of damage to corruption of inability to access or inability to manipulate electronic data. As used in this exclusion electronic data means information facts or programs stored as or on created or used on or transmitted to or from computer software including systems and applications software hard or floppy disks CD ROMS tapes drives cells data processing devices or any other media which are used with electronically controlled equipment. q. Nuclear Bodily injury or property damage 1 With respect to which an insured under the policy is also insured under a nuclear energy liability policy issued by Nuclear Energy Liability Insurance Association Mutual Atomic Energy Liability Underwriters Nuclear Insurance Association of Canada or any other similar nuclear energy liability insurance underwriting association or organization or any of their successors or would be an insured under any such policy but for its termination upon exhaustion of its limit of liability or Resulting from the hazardous properties of nuclear material and with respect to which a any person or organization is required to maintain financial protection pursuant to the Atomic Energy Act of 1954 or any other law or regulation requiring the insured to maintain such financial protection or any law amendatory thereof or b the insured is or had this policy not been issued would be entitled to indemnity from the United States of America or any other country or any agency thereof under any agreement entered into by the United States of America or any other country or any agency thereof with any person or organization. 3 Resulting from hazardous properties of nuclear material if a The nuclear material i. is at any nuclear facility owned by or operated by or on behalf of an insured or ii. has been discharged or dispersed therefrom b The nuclear material is contained in spent fuel or waste at any time possessed handled used processed stored transported or disposed of by or on behalf of an insured or K4F 2122016 IT7025 version date 07 2014 Page 6 of 27 Includes material reprinted with permission of ISO Properties Inc. | 1 |
r. c The bodily injury or property damage arises out of the furnishing by an insured of services materials parts or equipment in connection with the planning construction maintenance operation or use of any nuclear facility. Asbestos Bodily injury or property damage arising out of or in any way related to the actual alleged or threatened presence of or exposure to asbestos in any form or to any substance produced or released by asbestos whether or not the asbestos was at any time 1 Airborne as a fiber particle or dust 2 Contained in or formed a part of a product structure or other real or personal property 3 Carried on clothing 4 Inhaled or ingested or 5 Transmitted by any other means and including any 1 Claim suit demand judgment obligation order request settlement or statutory or regulatory requirement that any insured or others test for monitor clean up store handle transport abate remove contain treat dispose of detoxify or neutralize or in any way respond to or assess the effects of asbestos or Claim suit demand judgment obligation order request or settlement pertaining to any actual alleged or threatened injury cost or damage directly or indirectly from asbestos or associated with the testing for monitoring cleaning up storing handling transporting abating removing containing treating disposing of detoxifying or neutralizing or in any way responding to or assessing the effects of asbestos by any insured or by any other person or 3 Obligation or request to investigate settle or defend any claim or suit alleging any of the above. For purposes of this exclusion asbestos includes without limitation any asbestos containing material product substance or dust. German Environmental Liability Act Bodily injury or property damage arising out of or in any way related to or any loss cost expense or obligation imposed by or under the German Environmental Liability Act of 1990 and any amendments thereto. Silica or Silica Related Dust 1 Bodily injury arising in whole or in part out of the actual alleged threatened or suspected respiration inspiration inhalation breathing in or ingestion of silica or silica related dust. Property damage arising in whole or in part out of the actual alleged threatened or suspected contact with exposure to existence of or presence of silica or silica related dust. 3 Any loss cost or expense arising in whole or in part out of the abating testing for monitoring cleaning up removing containing treating detoxifying neutralizing remediating or disposing of or in any way responding to or assessing the effects of silica or silica related dust by any insured or by any other person or entity. K4F 2122016 IT7025 version date 07 2014 Page 7 of 27 Includes material reprinted with permission of ISO Properties Inc. | 1 |
u. Distribution of material in violation of statutes Bodily injury or property damage arising directly or indirectly out of any action or omission that violates or is alleged to violate 1 The Telephone Consumer Protection Act TCPA including any amendment of or addition to such law or 2 The CAN SPAM Act of 2003 including any amendment of or addition to such law or 3 Any statute ordinance or regulation other than the TCPA or CAN SPAM Act of 2003 that prohibits or limits the sending transmitting communicating or distribution of material or information or any similar foreign law. v. Lead Bodily injury or property damage arising out of or in any way related to the toxic properties of lead or lead containing products materials or substances. This exclusion applies to all forms of lead including but not limited to solid liquid vapor and fumes. This exclusion applies but is not limited to any bodily injury property damage expense cost loss liability or legal obligation to test for monitor abate remove treat or take any remedial action with respect to lead or lead containing products materials or substances. This exclusion does not imply that other policy provisions including but not limited to any pollution exclusion do not also exclude coverage for lead related injury damage expense cost loss liability or legal obligation. w. Clinical Trials Bodily injury or property damage arising out of or allegedly arising out of or in any way related to clinical trials. Only the exclusions a. Expected Or Intended Injury and b. Contractual Liability apply to damage by fire to premises while rented to you or temporarily occupied by you with permission of the owner. A separate Limit of Insurance applies to this coverage as described in SECTION Il LIMITS OF INSURANCE. COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY 1. Insuring Agreement a. Payment 1 We will pay those sums that the insured becomes legally obligated to pay as damages because of personal and advertising injury to which this insurance applies. 2 The amount we will pay as damages under subparagraph a.1 is limited as described in SECTION Ill LIMITS OF INSURANCE. b. Defense Investigation or Settlement 1 We will have the right and duty to defend the insured against any suit seeking damages for personal and advertising injury. However we will have no duty to defend the insured against any suit seeking damages for personal and advertising injury to which insurance does not apply K4F 2122016 IT7025 version date 07 2014 Page 8 of 27 Includes material reprinted with permission of ISO Properties Inc. | 1 |
2 We may at our discretion investigate any offense and settle any claim or suit that may result or 3 Our right and duty to defend under subparagraph b.1 ends when we have used up the applicable Limit of Insurance in the payment of judgments or settlements under Coverages A or B or medical expenses under Coverage C. No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under Supplementary Payments Coverages A and B. How This Insurance Applies This insurance applies to personal and advertising injury only if 1 The personal and advertising injury is caused by an offense arising out of your business and 2 The offense was committed in the coverage territory during the policy period and 2. Exclusions For Coverage B This insurance does not apply to a. Knowing Violation of Rights of Another Personal and advertising injury caused by or at the direction of the insured with the knowledge that the act would violate the rights of another and would inflict personal and advertising injury. Material Published with Knowledge of Falsity Personal and advertising injury arising out of oral or written publication of material if done by or at the direction of the insured with knowledge of its falsity. Material Published Prior to Policy Period Personal and advertising injury arising out of oral or written publication of material whose first publication took place before the beginning of the policy period. Criminal Acts Personal and advertising injury arising out of a criminal act committed by or at the direction of any insured. Contractual Liability Personal and advertising injury for which the insured has assumed liability in a contract or agreement. This exclusion does not apply to liability for damages that the insured would have in the absence of the contract or agreement or for an insured contract. Breach of Contract Personal and advertising injury arising out of a breach of contract except an implied contract to use another s advertising idea in your advertisement. Quality or Performance of Goods Failure to Conform to Statements Personal and advertising injury arising out of the failure of goods products or services to conform with any statement of quality or performance made in your advertisement. K4F 2122016 IT7025 version date 07 2014 Page 9 of 27 Includes material reprinted with permission of ISO Properties Inc. | 1 |
Wrong Description of Prices Personal and advertising injury arising out of the wrong description of the price of goods products or services stated in your advertisement. Infringement of Copyright Patent Trademark or Trade Secret Personal and advertising injury arising out of the infringement of copyright patent trademark trade secret or other intellectual property rights. However this exclusion does not apply to infringement in your advertisement of copyright trade dress or slogan. Under this exclusion such other intellectual property rights do not include the use of another s advertising idea in your advertisement. Insureds in Media and Internet Type Businesses Personal and advertising injury committed by an insured whose business is 1 Advertising broadcasting publishing or telecasting 2 Designing or determining content of web sites for third parties or 3 An Internet search access content or service provider. However this exclusion does not apply to Paragraphs 22. a. b. and c. of personal and advertising injury as defined under SECTION V DEFINITIONS. For the purposes of this exclusion the placing of frames borders or links or advertising for you or others anywhere on the Internet is not by itself considered the business of advertising broadcasting publishing or telecasting. Electronic Chatrooms or Bulletin Boards Personal and advertising injury arising out of an electronic chatroom or bulletin board an insured hosts or owns or over which an insured exercises control. Unauthorized Use of Another s Name or Product Personal and advertising injury arising out of the unauthorized use of another s name or production in your e mail address domain name or metatag or any other similar tactics to mislead another s potential customer.. Pollution Personal and advertising injury arising out of or in any way related to pollution however caused. Pollution Related Any loss cost or expense arising out of any 1 Request demand or order that any insured or others test for monitor clean up remove contain treat detoxify or neutralize or in any way respond to or assess the effects of pollutants or 2 Claim or suit by or on behalf of a governmental authority for damages because of testing for monitoring cleaning up removing containing treating detoxifying or neutralizing or in any way responding to or assessing the effects of pollutants. K4F 2122016 IT7025 version date 07 2014 Page 10 of 27 Includes material reprinted with permission of ISO Properties Inc. | 1 |
0. Asbestos Personal and advertising injury arising out of or in any way related to the actual alleged or threatened presence of or exposure to asbestos in any form or to any substance produced or released by asbestos whether or not the asbestos was at any time 1 Airborne as a fiber particle or dust 2 Contained in or formed a part of a product structure or other real or personal property 3 Carried on clothing 4 Inhaled or ingested or 5 Transmitted by any other means and including any 1 Claim suit demand judgment obligation order request settlement or statutory or regulatory requirement that any insured or others test for monitor clean up store handle transport abate remove contain treat dispose of detoxify or neutralize or in any way respond to or assess the effects of asbestos or 2 Claim suit demand judgment obligation order request or settlement pertaining to any actual alleged or threatened injury cost or damage directly or indirectly from asbestos or associated with the testing for monitoring cleaning up storing handling transporting abating removing containing treating disposing of detoxifying or neutralizing or in any way responding to or assessing the effects of asbestos by any insured or by any other person or 3 Obligation or request to investigate settle or defend any claim or suit alleging any of the above. For purposes of this exclusion asbestos includes without limitation any asbestos containing material product substance or dust. p. War Personal and advertising injury however caused arising directly or indirectly out of 1 War including undeclared or civil war Warlike action by a military force including action in hindering or defending against an actual or expected attack by any government sovereign or other authority using military personnel or other agents or 3 Insurrection rebellion revolution usurped power or action taken by governmental authority in hindering or defending against any of these. q. German Environmental Liability Act Personal and advertising injury arising out of or in any way related to or any loss cost expense or obligation imposed by or under the German Environmental Liability Act of 1990 and any amendments thereto. r. Silica or Silica Related Dust 1 Personal and advertising injury arising in whole or in part out of the actual alleged threatened or suspected respiration inspiration inhalation breathing in or ingestion of contact with exposure to existence of or presence of silica or silica related dust. K4F 2122016 IT7025 version date 07 2014 Page 11 of 27 Includes material reprinted with permission of ISO Properties Inc. | 1 |
t. 2 Any loss cost or expense arising in whole or in part out of the abating testing for monitoring cleaning up removing containing treating detoxifying neutralizing remediating or disposing of or in any way responding to or assessing the effects of silica or silica related dust by any insured or by any other person or entity. Distribution of Material In Violation of Statutes Personal and advertising injury arising directly or indirectly out of any action or omission that violates or is alleged to violate The Telephone Consumer Protection Act TCPA including any amendment of or addition to such law or 3 The CAN SPAM Act of 2003 including any amendment of or addition to such law or Any statute ordinance or regulation other than the TCPA or CAN SPAM Act of 2003 that prohibits or limits the sending transmitting communicating or distribution of material or information or any similar foreign law statute ordinance or regulation. Lead Personal and advertising injury arising out of or in any way related to the toxic properties of lead or lead containing products materials or substances. This exclusion applies to all forms of lead including but not limited to solid liquid vapor and fumes. This exclusion applies but is not limited to any personal and advertising injury expense cost loss liability or legal obligation to test for monitor abate remove treat or take any remedial action with respect to lead or lead containing products materials or substances. This exclusion does not imply that other policy provisions including but not limited to any pollution exclusion do not also exclude coverage for lead related injury damage expense cost loss liability or legal obligation. Clinical Trials Personal or advertising injury arising out of or allegedly arising out of or in any way related to clinical trials. Nuclear Personal or advertising injury 1 With respect to which an insured under the policy is also insured under a nuclear energy liability policy issued by Nuclear Energy Liability Insurance Association Mutual Atomic Energy Liability Underwriters Nuclear Insurance Association of Canada or any other similar nuclear energy liability insurance underwriting association or organization or any of their successors or would be an insured under any such policy but for its termination upon exhaustion of its limit of liability or 2 Resulting from the hazardous properties of nuclear material and with respect to which a any person or organization is required to maintain financial protection pursuant to the Atomic Energy Act of 1954 or any other law or regulation requiring the insured to maintain such financial protection or any law amendatory thereof or b the insured is or had this policy not been issued would be entitled to indemnity from the United States of America or any other country or any agency thereof under any agreement K4F 2122016 IT7025 version date 07 2014 Page 12 of 27 Includes material reprinted with permission of ISO Properties Inc. | 1 |
entered into by the United States of America or any other country or any agency thereof with any person or organization. 3 Resulting from hazardous properties of nuclear material if a The nuclear material i. is at any nuclear facility owned by or operated by or on behalf of an insured or ii. has been discharged or dispersed therefrom b The nuclear material is contained in spent fuel or waste at any time possessed handled used processed stored transported or disposed of by or on behalf of an insured or c The personal or advertising injury arises out of the furnishing by an insured of services materials parts or equipment in connection with the planning construction maintenance operation or use of any nuclear facility. COVERAGE C MEDICAL PAYMENTS 1. Insuring Agreement a. We will pay medical expenses as described below for bodily injury caused by an accident 1 On premises you own or rent 2 On ways next to premises you own or rent or 3 Because of your operations provided that a The accident takes place in the coverage territory and during the Policy Period b The expenses are incurred and reported to us within one year of the date of the accident and c The injured person submits to examination at our expense by physicians of our choice as often as we reasonably require. We will make these payments regardless of fault. These payments will not exceed the applicable Limit of Insurance. We will pay reasonable expenses for 1 First aid administered at the time of an accident 2 Necessary medical surgical x ray and dental services including prosthetic devices and 3 Necessary ambulance hospital professional nursing and funeral services. 2. Exclusions for Coverage C We will not pay for expenses for bodily injury a. Any Insured To any insured except volunteer workers. Hired Person To a person hired to do work for or on behalf of any insured or a tenant of any insured. K4F 2122016 IT7025 version date 07 2014 Page 13 of 27 Includes material reprinted with permission of ISO Properties Inc. | 1 |
Injury on Normally Occupied Premises To a person injured on that part of premises you own or rent that the person normally occupies. Workers Compensation and Similar Laws To a person whether or not an employee of any insured if benefits for the bodily injury are payable or must be provided under workers compensation and similar laws or disability benefits law or a similar law. Athletics Activities To a person injured while practicing instructing or participating in any physical exercises or games sports or athletic contests. Products Completed Operations Hazard Included within the products completed operations hazard. Coverage A Exclusions Excluded under Coverage A. Nuclear To expenses incurred with respect to bodily injury resulting from the hazardous properties of nuclear material and arising out of the operation of a nuclear facility by any person or organization. SUPPLEMENTARY PAYMENTS COVERAGES A AND B 1. We will pay with respect to any claim we investigate or settle or any suit against an insured we defend a. b. All expenses we incur. Up to 250 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish the bonds. The cost of bonds to release attachments but only for the bond amounts within the applicable Limit of Insurance. We do not have to furnish the bonds. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or suit including actual loss of earnings up to 250 a day because of time off from work. Al court costs taxed against the insured in the suit. Prejudgment interest awarded against the insured on that part of the judgment we pay. If we make an offer to pay the applicable Limit of Insurance we will not pay any prejudgment interest based on that period of time after the offer. All interest on the full amount of any judgment that accrues after entry of the judgment and before we have paid offered to pay or deposited in court the part of that judgment that is within the applicable Limit of Insurance. These payments will not reduce the Limits of Insurance. If we defend an insured against a suit and an indemnitee of the insured is also named as a party to the suit we will defend that indemnitee if all of the following conditions are met K4F 2122016 IT7025 version date 07 2014 Page 14 of 27 Includes material reprinted with permission of ISO Properties Inc. | 1 |
a. The suit against the indemnitee seeks damages for which the insured has assumed the liability of the indemnitee in a contract or agreement that is an insured contract b. This insurance applies to such liability assumed by the insured c. The obligation to defend or the cost of the defense of that indemnitee has also been assumed by the insured in the same insured contract d. The allegations in the suit and the information we know about the occurrence are such that no conflict appears to exist between the interests of the insured and the interests of the indemnitee e. The indemnitee and the insured ask us to conduct and control the defense of that indemnitee against such suit and agree that we can assign the same counsel to defend the insured and the indemnitee and f. The indemnitee 1 Agrees in writing to a Cooperate with us in the investigation settlement or defense of the suit b Immediately send us copies of any demands notices summonses or legal papers received in connection with the suit c Notify any other insurer whose coverage is available to the indemnitee and d Cooperate with us with respect to coordinating other applicable insurance available to the indemnitee and 2 Provides us with written authorization to a Obtain records and other information related to the suit and b Conduct and control the defense of the indemnitee in such suit. As long as the above conditions are met attorneys fees incurred by us in the defense of that indemnitee necessary litigation expenses incurred by us and necessary litigation expenses incurred by the indemnitee at our request will be paid as Supplementary Payments. Notwithstanding the provisions of paragraph 2.b.2 of SECTION COVERAGES COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY such payments will not be deemed to be damages for bodily injury and property damage and will not reduce the Limits of Insurance. Our obligation to defend an insured s indemnitee and to pay for attorneys fees and necessary litigation expenses as Supplementary Payments ends when a. We have used up the applicable limit of insurance in the payment of judgments or settlements or b. The conditions set forth above or the terms of the agreement described in Paragraph f. above are no longer met. SECTION Il WHO IS AN INSURED 1. If you are designated in the Declarations as a. Anindividual you and your spouse are insureds but only with respect to the conduct of a business of which you are the sole owner. K4F 2122016 IT7025 version date 07 2014 Page 15 of 27 Includes material reprinted with permission of ISO Properties Inc. | 1 |
b. A partnership or joint venture you are an insured. Your members your partners and their spouses are also insureds but only with respect to the conduct of your business. c. A limited liability company you are an insured. Your members are also insureds but only with respect to the conduct of your business. Your managers are insureds but only with respect to their duties as your managers. d. An organization other than a partnership joint venture or limited liability company you are an insured. Your executive officers and directors are insureds but only with respect to their duties as your officers or directors. Your stockholders are also insureds but only with respect to their liability as stockholders. e. Atrust you are an insured. Your trustees are also insureds but only with respect to their duties as trustees. Each of the following is also an insured a. Your volunteer workers only while performing duties related to the conduct of your business or your employees other than either your executive officers if you are an organization other than a partnership joint venture or limited liability company or your managers if you are a limited liability company but only for acts within the scope of their employment by you or while performing duties related to the conduct of your business. However none of these employees or volunteer workers is an insured for 1 Bodily injury or personal and advertising injury a To you to your partners or members if you are a partnership or joint venture to your members if you are a limited liability company or to a coemployee while in the course of his or her employment or performing duties related to the conduct of your business or to your other volunteer workers while performing duties related to the conduct of your business or b To the spouse child parent brother or sister of that coemployee or volunteer worker as a consequence of paragraph 1a above c For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in paragraphs 1a or b above or d Arising out of his or her providing or failing to provide professional health care services. 2 Property damage to property a Owned occupied or used by b Rented to or in the care custody or control of or over which physical control is being exercised for any purpose by you any of your employees volunteer workers any partner or member if you are a partnership or joint venture or any member if you are a limited liability company. b. Any property managers or lessors of premises leased to you but only for injury or damage for which you have assumed liability in a contract or agreement that is an insured contract and which arises out of the ownership maintenance or use of that part of the premises leased to you. However this insurance does not apply to 1 Any occurrence which takes place after you cease to be a tenant in that premises 2 Structural alterations new construction or demolition operations performed by of on behalf of the manager or lessor of premises K4F 2122016 IT7025 version date 07 2014 Page 16 of 27 Includes material reprinted with permission of ISO Properties Inc. | 1 |
3. c. Any person other than your employee or volunteer worker or any organization while acting as your real estate manager. d. Any person or organization having proper temporary custody of your property if you die but only 1 With respect to liability arising out of the maintenance or use of that property and 2 Until your legal representative has been appointed. e. Your legal representative if you die but only with respect to duties as such. That representative will have all of your rights and duties under this Coverage Form. Any organization you newly acquire or form other than a partnership joint venture or limited liability company and over which you maintain ownership or majority interest will qualify as a Named Insured if there is no other similar insurance available to that organization. However a. Coverage under this provision is afforded only until the 180 day after you acquire or form the organization or the end of the policy period whichever is earlier b. Coverage A does not apply to bodily injury or property damage that occurred before you acquired or formed the organization and c. Coverage B does not apply to personal and advertising injury arising out of an offense committed before you acquired or formed the organization. No person or organization is an insured with respect to the conduct of any current or past partnership joint venture or limited liability company that is not shown as a Named Insured in the Declarations. SECTION Il LIMITS OF INSURANCE 1. The Limits of Insurance for COMMERCIAL GENERAL LIABILITY COVERAGE shown in the Declarations and the rules below fix the most we will pay regardless of the number of a. Insureds b. Claims made or suits brought or c. Persons or organizations making claims or bringing suits. The General Aggregate Limit is the most we will pay for the sum of a. Medical expenses under Coverage C b. Damages under Coverage A except damages because of bodily injury or property damage included in the products completed operations hazard and c. Damages under Coverage B. The Products Completed Operations Aggregate Limit is the most we will pay under Coverage A for damages because of bodily injury and property damage included in the products completed operations hazard. Subject to paragraph 2. above the Personal and Advertising Injury Limit is the most we will pay under Coverage B for the sum of all damages because of all personal and advertising injury sustained by any one person or organization. Subject to paragraph 2. or 3. above whichever applies the Each Occurrence Limit is the most we will pay for the sum of a. Damages under Coverage A and K4F 2122016 IT7025 version date 07 2014 Page 17 of 27 Includes material reprinted with permission of ISO Properties Inc. | 1 |
b. Medical expenses under Coverage C. because of all bodily injury and property damage arising out of any one occurrence. 6. Subject to paragraph 5. above the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of property damage to any one premises while rented to you or temporarily occupied by you with permission of the owner. 7. Subject to paragraph 5. above the Medical Expense Limit is the most we will pay under Coverage C for all medical expenses because of bodily injury sustained by any one person. The Limits of Insurance of this Coverage Form apply separately to each consecutive annual period and to any remaining period of less than 12 months starting with the beginning of the policy period shown in the Declarations unless the policy period is extended after issuance for an additional period of less than 12 months. In that case the additional period will be deemed part of the last preceding period for purposes of determining the Limits of Insurance. SECTION IV COMMERCIAL GENERAL LIABILITY CONDITIONS 1. Bankruptcy Bankruptcy or insolvency of the insured or of the insured s estate will not relieve us of our obligations under this Coverage Form. 2. Duties in the Event of Occurrence Offense Claim or Suit a. You must see to it that we are notified as soon as practicable of an occurrence or an offense which may result in a claim. To the extent possible notice should include 1 How when and where the occurrence or offense took place 2 The names and addresses of any injured person and witnesses and 3 The nature and location of any injury or damage arising out of the occurrence or offense. b. If aclaimis made or suit is brought against any insured you must 1 Immediately record the specifics of the claim or suit and the date received and 2 Notify us as soon as practicable. You must see to it that we receive written notice of the claim or suit as soon as practicable. c. You and any other involved insured must Immediately send us copies of any demands notices summonses or legal papers received in connection with the claim or suit 3 Authorize us to obtain records and other information Cooperate with us in the investigation or settlement of the claim or defense against the suit and Assist us upon our request in the enforcement of any right against any person or organization which may be liable to the insured because of injury or damage to which this insurance may also apply. d. No insured will except at that insured s own cost voluntarily make a payment assume any obligation or incur any expense other than for first aid without our consent. K4F 2122016 IT7025 version date 07 2014 Page 18 of 27 Includes material reprinted with permission of ISO Properties Inc. | 1 |
3. Knowledge of Occurrence or Offense Knowledge of an occurrence or offense by the agent servant or employee of any insured will not in itself constitute knowledge by that insured unless one of that insured s executive officers or anyone responsible for administering that insured s insurance program has knowledge of the same or has been notified of the same by the agent servant or employee. 4. Legal Action Against Us No person or organization has a right under this Coverage Form a. To join us as a party or otherwise bring us into a suit asking for damages from an insured or b. To sue us on this Coverage Form unless all of its terms have been fully complied with. A person or organization may sue us to recover on an agreed settlement or on a final judgment against an insured obtained after an actual trial but we will not be liable for damages that are not payable under the terms of this Coverage Form or that are in excess of the applicable Limit of Insurance. An agreed settlement means a settlement and release of liability signed or agreed to by us the insured and the claimant or the claimant s legal representative. 5. Notice of Occurrence or Offense If you report an occurrence or offense to an insurer providing other than General Liability insurance which later develops into a General Liability claim covered under this policy failure to report such occurrence or offense to us at the time of the occurrence or offense will not be deemed to be in violation of Duties in the Event of Occurrence Offense Claim or Suit conditions provided that you notify us as soon as you become aware that the occurrence or offense is a General Liability claim. 6. Other Insurance If other valid and collectible insurance is available to the insured for a loss we cover under SECTION I COVERAGES COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY or COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY our obligations are limited as follows a. Primary Insurance 1 This insurance is primary when the conditions of that other insurance or any underlyer policy do not apply to a loss covered by this insurance except when the provisions of paragraph b. below apply. 2 If the conditions of that other insurance not including any underlyer policy apply to a loss covered by this insurance and any of that other insurance is primary we will share with all that other insurance by the method described in paragraph e. below. b. Excess Insurance This insurance is excess over 1 Any other insurance whether primary excess contingent or on any other basis a That is Fire Extended Coverage Builder s Risk Installation Risk or similar coverage for your work b That is Fire Extended Coverage or similar coverage for premises rented to you or temporarily occupied by you with permission of the owner c That is insurance purchased by you to cover your liability as a tenant for property damage to premises rented to you or temporarily occupied by you with permission of the owner or IT7025 version date 07 2014 Page 19 of 27 K4F 2122016 Includes material reprinted with permission of ISO Properties Inc. | 1 |
d If the loss arises out of the maintenance or use of aircraft autos or watercraft to the extent not subject to the exclusion in Section COVERAGES COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY 2. Exclusions for Coverage A g. Aircraft Autos Watercraft 2 Any other primary insurance available to you covering liability for damages arising out of the premises or operations or the products and completed operations for which you have been added as an additional insured by attachment of an endorsement. 3 Any other valid and collectible insurance that is a An underlyer policy b Issued in a country other than the country in which this insurance was issued or c Issued in this country. When this insurance is excess over any other insurance described in paragraph b.3a b or c above our Limits of Insurance will be reduced by the amount of that other insurance including any deductibles or self insured retention amounts. When this insurance is excess we will have no duty under COVERAGE A. or COVERAGE B. to defend any claim or suit that any other insurer has a duty to defend. If any other insurer defends we will have the right but not the duty and be given the opportunity to be associated in the defense and trial of any suit relative to any occurrence or offense which in our opinion may create liability on our part under the terms of this Coverage Form. If no other insurer defends we will undertake to do s0 but we will be entitled to the insured s rights against all those other insurers. When this insurance is excess over other insurance we will pay only our share of the amount of the loss if any that exceeds the sum of 1 the total amount that all such other insurance would pay for the loss in the absence of this insurance and 2 the total of all deductible and self insured amounts under that other insurance. We will share the remaining loss if any with other insurance that is not described in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Form. Method of Sharing If all of the other insurance permits contribution by equal shares we will follow this method also. Under this approach each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains whichever comes first. If any of the other insurance does not permit contribution by equal shares we will contribute by limits. Under this method each insurer s share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. Notwithstanding anything to the contrary contained herein in the event such other insurance is not valid or collectible because of bankruptcy insolvency refusal or inability to pay of any insurer of any underlyer policy we will indemnify the first named insured on the Declarations of this Coverage Form on a primary basis subject to the terms and conditions of this Coverage Form. However we will not assume any obligation under such underlyer policy and you will assign to us your rights to any proceeds under such underlyer policy. K4F 2122016 IT7025 version date 07 2014 Page 20 of 27 Includes material reprinted with permission of ISO Properties Inc. | 1 |
7. Representations and Warranties By accepting this policy you agree a. The statements and warranties in this policy including but not limited to warranties contained within the policy forms and any statements in the Declarations are accurate and complete b. Those statements and warranties constitute representations the first Named Insured shown on the Declarations made to us and c. We have issued the policy in reliance upon those representations. Separation of Insureds Except with respect to the Limits of Insurance and any rights or duties specifically assigned in this Coverage Form to the first Named Insured this insurance applies a. As if each Named Insured were the only Named Insured and b. Separately to each insured against whom claim is made or suit is brought. SECTION V DEFINITIONS 1. Advertisement means a notice that is broadcast or published to the general public or specific market segments about your goods products or services for the purpose of attracting customers or supporters. For the purposes of this definition a. Notices that are published include material placed on the Internet or on similar electronic means of communication and b. Regarding web sites only that part of a website that is about your goods products or services for the purposes of attracting customers or supporters is considered an advertisement. Auto means a. A land motor vehicle trailer or semi trailer designed for travel on public roads including any attached machinery or equipment or b. Any other land vehicle that is subject to a compulsory or financial responsibility law or other motor vehicle insurance law in the state or country where it is licensed or principally garaged. However auto does not include mobile equipment. Biologic means any product such as a globulin serum vaccine antitoxin antigen or analogous product used in the prevention of treatment of sickness or disease. Biologic products also include blood and blood components used for transfusion or for the manufacture of pharmaceuticals derived from blood and blood components such as clotting factors. Bodily injury means bodily injury sickness or disease sustained by a person including death resulting from any of these at any time. By product material has the meaning given in the Atomic Energy Act of 1954 as amended. Clinical trials means any organized research clinical evaluation testing study or analysis of products or procedures which adheres to a written protocol for the same and which provides clinical data for the assessment of the effects of a pharmaceutical biologic or medical device on humans. Coverage territory means Coverage Territory for Liability Coverages shown in the Declarations. The coverage territory also includes K4F 2122016 IT7025 version date 07 2014 Page 21 of 27 Includes material reprinted with permission of ISO Properties Inc. | 1 |
11. 12. 13. a. International waters or airspace provided the injury or damage does not occur in the course of travel or transportation from one place to another when both places are within the United States of America including it s territories and possessions Puerto Rico and Canada b. The United States of America including its territories and possessions Puerto Rico and Canada if the insured s responsibility to pay damages is determined in a suit on the merits in any country other than the United States of America including its territories or possessions Puerto Rico and Canada. Employee includes a leased worker. Employee does not include a temporary worker. Environment includes any air land structure or the air therein watercourse or water including underground water.. Executive officer means a person holding any of the officer positions created by your charter constitution by laws or any other similar governing document. Hazardous properties includes radioactive toxic or explosive properties Impaired property means tangible property other than your product or your work that can not be used or is less useful because a. It incorporates your product or your work that is known or thought to be defective deficient inadequate or dangerous or b. You have failed to fulfill the terms of a contract or agreement if such property can be restored to use by a. The repair replacement adjustment or removal of your product or your work or b. Your fulfilling the terms of the contract or agreement. Insured contract means a. A contract for a lease of premises. However that portion of the contract for a lease of premises that indemnifies any person or organization for damage to premises while rented to you or temporarily occupied by you with permission of the owner is not an insured contract. b. A sidetrack agreement c. Any easement or license agreement except in connection with construction or demolition operations on or within 50 feet of a railroad d. An obligation as required by ordinance to indemnify a municipality except in connection with work for a municipality e. An elevator maintenance agreement f. That part of any other contract or agreement pertaining to your business including an indemnification of a municipality in connection with work performed for a municipality under which you assume the tort liability of another party to pay for bodily injury or property damage to a third person or organization. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement. Paragraph f. does not include that part of any contract or agreement 1 That indemnifies a railroad for bodily injury or property damage arising out of construction or demolition operations within 50 feet of any railroad property and affecting any railroad bridge or trestle tracks road beds tunnel underpass or crossing K4F 2122016 IT7025 version date 07 2014 Page 22 of 27 Includes material reprinted with permission of ISO Properties Inc. | 1 |
2 Thatindemnifies an architect engineer or surveyor for injury or damage arising out of a Preparing approving or failing to prepare or approve maps shop drawings opinions reports surveys field orders change orders or drawings and specifications or b Giving directions or instructions or failing to give them if that is the primary cause of the injury or damage or 3 Under which the insured if an architect engineer or surveyor assumes liability for an injury or damage arising out of the insured s rendering or failure to render professional services including those listed in 2 above and supervisory inspection architectural or engineering activities. 14. Leased worker means a person leased to you by a labor leasing firm under an agreement between you 15. 16. 17. and the labor leasing firm to perform duties related to the conduct of your business. Leased worker does not include a temporary worker. Loading or unloading means the handling of property a. b. c. After it is moved from the place where it is accepted for movement into or onto an aircraft watercraft or auto While it is in or on an aircraft watercraft or auto or While it is being moved from an aircraft watercraft or auto to the place where it is finally delivered but loading or unloading does not include the movement of property by means of a mechanical device other than a hand truck that is not attached to the aircraft watercraft or auto. Medical device means any product other than a pharmaceutical or biologic which has an application in therapeutic or diagnostic medicine. Mobile equipment means any of the following types of land vehicles including any attached machinery or equipment a. b. Bulldozers farm machinery forklifts and other vehicles designed for use principally off public roads Vehicles maintained for use solely on or next to premises you own or rent Vehicles that travel on crawler treads Vehicles whether self propelled or not maintained primarily to provide mobility to permanently mounted 1 Power cranes shovels loaders diggers or drills or 2 Road construction or resurfacing equipment such as graders scrapers or rollers Vehicles not described in a. b. c. or d. above that are not self propelled and are maintained primarily to provide mobility to permanently attached equipment of the following types 1 Air compressors pumps and generators including spraying welding building cleaning geophysical exploration lighting and well servicing equipment or 2 Cherry pickers and similar devices used to raise or lower workers K4F 2122016 IT7025 version date 07 2014 Page 23 of 27 Includes material reprinted with permission of ISO Properties Inc. | 1 |
18. 19. 20. 21. 22. f. Vehicles not described in a. b. c. or d. above maintained primarily for purposes other than the transportation of persons or cargo. However self propelled vehicles with the following types of permanently attached equipment are not mobile equipment but will be considered autos 1 Equipment designed primarily for a Snow removal b Road maintenance but not construction or resurfacing or c Street cleaning 2 Cherry pickers and similar devices mounted on automobile or truck chassis and used to raise or lower workers and 3 Air compressors pumps and generators including spraying welding building cleaning geophysical exploration lighting and well service equipment. However mobile equipment does not include any land vehicles that are subject to a compulsory or financial responsibility law or other motor vehicle insurance law in the state or country where it is licensed or principally garaged. Land vehicles subject to a compulsory or financial responsibility law or other motor vehicle insurance law are considered autos. Nuclear facility means a. Any nuclear reactor b. Any equipment or device designed or used for 1 separating the isotopes of uranium or plutonium 2 processing or utilizing spent fuel or 3 handling processing or packaging wastes c. Any equipment or device used for the processing fabricating or alloying of special nuclear material if at any time the total amount of such material in the custody of the insured at the premises where such equipment or device is located consists of or contains more than 25 grams of plutonium or uranium 233 or any combination thereof or more than 250 grams of uranium 235 d. Any structure basin excavation premises or place prepared or used for storage or disposal of waste and includes the site on which any of the foregoing is located all operations conducted on such site and all premises used for such operations Nuclear material means source material special nuclear material or by product material. Nuclear reactor means any apparatus designed or used to sustain nuclear fission in a self supporting chain reaction or to contain a critical mass of fissionable material Occurrence means an accident including continuous or repeated exposure to substantially the same general harmful conditions. All such exposure to substantially the same general conditions shall be considered as arising out of the same occurrence regardless of the frequency or repetition thereof or the number of claimants. Personal and advertising injury means injury including consequential bodily injury arising out of one or more of the following offenses a. False arrest detention or imprisonment b. Malicious prosecution IT7025 version date 07 2014 Page 24 of 27 K4F 2122016 Includes material reprinted with permission of ISO Properties Inc. K4F 2122016 | 1 |
f. The wrongful eviction from wrongful entry into or invasion of the right of private occupancy of a room dwelling or premises that a person occupies committed by or on behalf of its owner landlord or lessor Oral or written publication in any manner of material that slanders or libels a person or organization or disparages a person s or organization s goods products or services Oral or written publication in any manner of material that violates a person s right of privacy The use of another s advertising idea in your advertisement or Infringing upon another s copyright trade dress or slogan in your advertisement. 23. Pharmaceutical means any substance administered orally topically or via injection to treat diagnose cure mitigate or prevent sickness or disease. 24. Pollution includes the actual alleged or potential presence in or introduction into the environment of any substance if such substance has or is alleged to have the effect of making the environment impure harmful or dangerous. 25. Products completed operations hazard a. Includes all bodily injury and property damage occurring away from premises you own or rent and arising out of your product or your work except 1 Products that are still in your physical possession or 2 Work that has not yet been completed or abandoned. However your work will be deemed completed at the earliest of the following times a When all of the work called for in your contract has been completed. b When all of the work to be done at the job site has been completed if your contract calls for work at more than one job site. c When that part of the work done at a job site has been put to its intended use by any person or organization other than another contractor or sub contractor working on the same project. Work that may need service maintenance correction repair or replacement but which is otherwise complete will be treated as completed. Does not include bodily injury or property damage arising out of The transportation of property unless the injury or damage arises out of a condition in or on a vehicle not owned or operated by you and that condition was created by the loading or unloading of that vehicle by any insured 2 The existence of tools uninstalled equipment or abandoned or unused materials or 3 Products or operations for which the classification listed in the Declarations or in a policy schedule states that products completed operations are subject to the General Aggregate Limit. 26. Property damage means a. Physical injury to tangible property including all resulting loss of use of that property. All such loss of use shall be deemed to occur at the time of the physical injury that caused it or Loss of use of tangible property that is not physically injured. All such loss of use shall be deemed to occur at the time of the occurrence that caused it. K4F 2122016 IT7025 version date 07 2014 Page 25 of 27 Includes material reprinted with permission of ISO Properties Inc. | 1 |
27. 28. 29. 30. 31. 32. 33. 34. 35. 36. 37. 38. For the purposes of this Coverage Form electronic data is not tangible property. As used in this definition electronic data means information facts or programs stored as or on created or used on or transmitted to or from computer software including systems and applications software hard or floppy disks CD ROMS tapes drives cells data processing devices or any other media which are used with electronically controlled equipment. For the purposes of the Nuclear exclusions property damage includes all forms of radioactive contamination of property. Silica means silicon dioxide occurring in crystalline amorphous and impure forms silica particles silica dust or silica compounds. Silica related dust means a mixture or combination of silica and other dust or particles. Source material has the meaning given in the Atomic Energy Act of 1954 as amended. Special nuclear material has the meaning given in the Atomic Energy Act of 1954 as amended. Spent fuel means any fuel element or fuel component solid or liquid which has been used or exposed to radiation in a nuclear reactor Suit means a civil proceeding in which damages because of bodily injury property damage or personal and advertising injury to which this insurance applies are alleged. Suit includes a. An arbitration proceeding in which such damages are claimed and to which the insured must submit or does submit with our consent or b. Any other alternative dispute resolution proceeding in which such damages are claimed and to which the insured submits with our consent. Temporary worker means a person who is furnished to you to substitute for a permanent employee on leave or to meet seasonal or short term workload conditions. Underlyer policy means an insurance policy that is issued by us or requested by us or our affiliated insurance company to be issued to you or one of your subsidiary or affiliated entities. Volunteer worker means a person who is not your employee and who donates his or her work and acts at the direction of and within the scope of duties determined by you and is not paid a fee salary or other compensation by you or anyone else for the work performed for you. Waste for purposes of the Nuclear exclusions means any waste material 1 containing by product material other than the tailings or wastes produced by the extraction or concentration of uranium or thorium from any ore processed primarily for its source material content and 2 resulting from the operation by any person or organization of any nuclear facility included under sub paragraph a or b of the definition of nuclear facility. Workers compensation or similar law means any workers compensation law occupational disease law disability benefits law or any other legal authority imposing liability for or requiring payment of compensation benefits medical care or loss of wages to an employee by reason of bodily injury or disease arising during the course of employment regardless of whether such payment is required to be made by the employer or any governmental entity. Your product means a. Any goods or products other than real property manufactured sold handled distributed or disposed of by K4F 2122016 IT7025 version date 07 2014 Page 26 of 27 Includes material reprinted with permission of ISO Properties Inc. | 1 |
1 You 2 Others trading under your name or 3 A person or organization whose business or assets you have acquired and b. Containers other than vehicles materials parts or equipment furnished in connection with such goods or products. Your product includes a. Warranties or representations made at any time with respect to the fitness quality durability performance or use of your product and b. The providing of or failure to provide warnings or instructions. Your product does not include vending machines or other property rented to or located for the use of others but not sold. 39. Your work means a. Work or operations performed by you or on your behalf and b. Materials parts or equipment furnished in connection with such work or operations. Your work includes a. Warranties or representations made at any time with respect to the fitness quality durability performance or use of your work and b. The providing of or failure to provide warnings or instructions. K4F 2122016 IT7025 version date 07 2014 Page 27 of 27 Includes material reprinted with permission of ISO Properties Inc. | 1 |
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aceusa EMPLOYEE BENEFITS LIABILITY COVERAGE FORM ENDORSEMENT THIS ENDORSEMENT PROVIDES CLAIMS MADE COVERAGE. EXCEPT AS OTHERWISE PROVIDED HEREIN THIS COVERAGE FORM COVERS ONLY CLAIMS FIRST MADE AGAINST THE INSUREDS AND REPORTED TO US DURING THE POLICY PERIOD. This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE FORM A. The following is added to SECTION COVERAGES EMPLOYEE BENEFITS LIABILITY COVERAGE 1. Insuring Agreement a. We will pay those sums that the insured becomes legally obligated to pay as damages because of any act error or omission of the insured or of any other person for whose acts the insured is legally liable to which this insurance applies. We will have the right and duty to defend the insured against any suit seeking those damages. However we will have no duty to defend the insured against any suit seeking damages to which this insurance does not apply. We may at our discretion investigate any report of an act error or omission and settle any claim or suit that may result. But 1 The amount we will pay for damages is limited as described in SECTION Ill LIMITS OF INSURANCE and 2 Our right and duty to defend ends when we have used up the applicable limit of insurance in the payment of judgments or settlements. No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under Supplementary Payments. b. This insurance applies to damages only if 1 The act error or omission is negligently committed in the administration of your employee benefit program 2 A claim for damages because of a negligent act error or omission is first made against any insured in accordance with Paragraph c. below during the policy period and 3 The negligent act error or omission in the administration of your employee benefit program was committed entirely within the Coverage Territory shown on the LIABILITY COVERAGES DECLARATIONS. c. A claim seeking damages will be deemed to have been made at the earlier of the following times 1 When notice of such claim is received and recorded by any insured or by us whichever comes first or 2 When we make settlement in accordance with Paragraph 1.a. above. IT7026 11 2012 Page 1 0of 6 K4F 2122016 Material reprinted in part with permission of ISO Properties Inc. K4F 2122016 | 2 |
All claims for damages made by an employee because of any act error or omission or a series of related acts errors or omissions including damages claimed by such employee s dependents and beneficiaries will be deemed to have been made at the time the first of those claims is made against any insured. 2. Exclusions This insurance does not apply to a. Dishonest Fraudulent Criminal Or Malicious Act Damages arising out of any intentional dishonest fraudulent criminal or malicious act error or omission committed by any insured including the willful or reckless violation of any statute. b. Bodily Injury Property Damage Or Personal And Advertising Injury Bodily injury property damage or personal and advertising injury. c. Failure To Perform A Contract Damages arising out of failure of performance of contract by any insurer. d. Insufficiency Of Funds Damages arising out of an insufficiency of funds to meet any obligations under any plan included in the employee benefit program. e. Inadequacy Of Performance Of Investment Advice Given With Respect To Participation Any claim based upon 1 Failure of any investment to perform 2 Errors in providing information on past performance of investment vehicles or 3 Advice given to any person with respect to that person s decision to participate or not to participate in any plan included in the employee benefit program. f. Workers Compensation And Similar Laws Any claim arising out of your failure to comply with the mandatory provisions of any workers compensation unemployment compensation insurance social security or disability benefits law or any similar law. g. ERISA Damages for which any insured is liable because of liability imposed on a fiduciary by the Employee Retirement Income Security Act of 1974 as now or hereafter amended or by any similar federal state or local laws. h. Available Benefits Any claim for benefits to the extent that such benefits are available with reasonable effort and cooperation of the insured from the applicable funds accrued or other collectible insurance. IT7026 11 2012 Page 2 0f 6 K4F 2122016 Material reprinted in part with permission of ISO Properties Inc. | 2 |
i. Taxes Fines Or Penalties Taxes fines or penalties including those imposed under the Internal Revenue Code or any similar state local or foreign law. j Employment Related Practices Damages arising out of wrongful termination of employment discrimination or other employment related practices. B. For the purposes of the coverage provided by this endorsement 1. 2. All references to SUPPLEMENTARY PAYMENTS COVERAGES A AND B are replaced by SUPPLEMENTARY PAYMENTS COVERAGES A B AND EMPLOYEE BENEFITS LIABILITY. Paragraphs 1.b. and 2. of the Supplementary Payments provision do not apply. C. For the purposes of the coverage provided by this endorsement Paragraph 2. of SECTION Il WHO IS AN INSURED is replaced by the following 2. Each of the following is also an insured a. Each of your employees who is or was authorized to administer your employee benefit program. b. Any persons organizations or employees having proper temporary authorization to administer your employee benefit program if you die but only until your legal representative is appointed. c. Your legal representative if you die but only with respect to duties as such. That representative will have all your rights and duties under this Endorsement. D. For the purposes of the coverage provided by this endorsement SECTION Il LIMITS OF INSURANCE is amended by adding the following 1. Limits Of Insurance for EMPLOYEE BENEFITS LIABILITY COVERAGE a. The Limits of Insurance shown in the Declarations and the rules below fix the most we will pay regardless of the number of 1 Insureds 2 Claims made or suits brought 3 Persons or organizations making claims or bringing suits 4 Acts errors or omissions or 5 Benefits included in your employee benefit program. b. The Annual Aggregate Limit is the most we will pay for all damages because of acts errors or omissions negligently committed in the administration of your employee benefit program. c. Subject to the Annual Aggregate Limit the Each Claim Limit is the most we will pay for all damages sustained by any employee including damages sustained by such employee s dependents and beneficiaries as a result of IT7026 11 2012 Page 3 of 6 Material reprinted in part with permission of ISO Properties Inc. K4F 2122016 | 2 |
1 An act error or omission or 2 A series of related acts errors or omissions negligently committed in the administration of your employee benefit program. However the amount paid under this endorsement shall not exceed and will be subject to the limits and restrictions that apply to the payment of benefits in any plan included in the employee benefit program. The Limits of Insurance for EMPLOYEE BENEFITS LIABILITY COVERAGE apply separately to each consecutive annual period and to any remaining period of less than 12 months starting with the beginning of the policy period shown in the Declarations unless the policy period is extended after issuance for an additional period of less than 12 months. In that case the additional period will be deemed part of the last preceding period for purposes of determining the Limits Of Insurance. Special Deductible for EMPLOYEE BENEFITS LIABILITY COVERAGE a. Our obligation to pay damages on behalf of the insured applies only to the amount of damages in excess of 1000 deductible as applicable to each claim. We will subtract this amount from the amount of damages payable for each claim. b. If there is a Deductible Endorsement however titled applicable to this Coverage Form the terms and conditions of such endorsement including but not limited to the deductible amount shall apply and the Special Deductible set forth in a. above shall be in addition to such deductible amount. E. For the purposes of the coverage provided by this endorsement Conditions 2. and 6. of SECTION IV COMMERCIAL GENERAL LIABILITY CONDITIONS are deleted and replaced by the following 2. Duties In The Event Of An Act Error Or Omission Or Claim Or Suit a. You must see to it that we are notified as soon as practicable of an act error or omission which may result in a claim. To the extent possible notice should include 1 What the act error or omission was and when it occurred and 2 The names and addresses of anyone who may suffer damages as a result of the act error or omission. b. If aclaimis made or suit is brought against any insured you must 1 Immediately record the specifics of the claim or suit and the date received and 2 Notify us as soon as practicable. You must see to it that we receive written notice of the claim or suit as soon as practicable. c. You and any other involved insured must 1 Immediately send us copies of any demands notices summonses or legal papers received in connection with the claim or suit 2 Authorize us to obtain records and other information 3 Cooperate with us in the investigation or settlement of the claim or defense against the suit and IT7026 11 2012 Page 4 of 6 Material reprinted in part with permission of ISO Properties Inc. K4F 2122016 | 2 |
4 Assist us upon our request in the enforcement of any right against any person or organization which may be liable to the insured because of an act error or omission to which this insurance may also apply. d. No insured will except at that insured s own cost voluntarily make a payment assume any obligation or incur any expense without our consent. 6. Other Insurance This insurance will be excess over any other valid and collectible insurance available to the insured for a loss covered by EMPLOYEE BENEFITS LIABILITY COVERAGE whether primary excess contingent or on any other basis. F. For the purposes of the coverage provided by this endorsement the following definitions are added to SECTION V DEFINITIONS 1. Administration means a. Providing information to employees including their dependents and beneficiaries with respect to eligibility for or scope of employee benefit programs b. Handling records in connection with the employee benefit program or c. Effecting continuing or terminating any employee s participation in any benefit included in the employee benefit program. However administration does not include handling payroll deductions. 2. Cafeteria plans means plans authorized by applicable law to allow employees to elect to pay for certain benefits with pre tax dollars. 3. Claim means any demand or suit made by an employee or an employee s dependents and beneficiaries for damages as the result of an act error or omission. 4. Employee benefit program means a program providing some or all of the following benefits to employees whether provided through a cafeteria plan or otherwise a. Group life insurance group accident or health insurance dental vision and hearing plans and flexible spending accounts provided that no one other than an employee may subscribe to such benefits and such benefits are made generally available to those employees who satisfy the plan s eligibility requirements b. Profit sharing plans employee savings plans employee stock ownership plans pension plans and stock subscription plans provided that no one other than an employee may subscribe to such benefits and such benefits are made generally available to all employees who are eligible under the plan for such benefits c. Unemployment insurance social security benefits workers compensation and disability benefits d. Vacation plans including buy and sell programs leave of absence programs including military maternity family and civil leave tuition assistance plans transportation and health club subsidies and e. Any other similar benefits designated in the Schedule or added thereto by endorsement. IT7026 11 2012 Page 5 of 6 Material reprinted in part with permission of ISO Properties Inc. K4F 2122016 | 2 |
G. For the purposes of the coverage provided by this endorsement SECTION V DEFINITIONS is amended by deleting paragraph 8. the definition of employee and paragraph 30. the definition of suit and replacing them respectively with the following 8. Employee means a person actively employed formerly employed on leave of absence or disabled or retired. Employee includes a leased worker. Employee does not include a temporary worker. 30. Suit means a civil proceeding in which damages because of an act error or omission to which this insurance applies are alleged. Suit includes a. An arbitration proceeding in which such damages are claimed and to which the insured must submit or does submit with our consent or b. Any other alternative dispute resolution proceeding in which such damages are claimed and to which the insured submits with our consent. All other terms conditions and exclusions of this policy remain unchanged. IT7026 11 2012 Page 6 of 6 Material reprinted in part with permission of ISO Properties Inc. K4F 2122016 | 2 |
aceusa CONTINGENT AUTO LIABILITY COVERAGE FORM THIS INSURANCE MAY NOT BE OFFERED IN SATISFACTION OF INSURANCE REQUIREMENTS OF ANY MOTOR VEHICLE LAW ANYWHERE. SECTION LIABILITY COVERAGE A. Insuring Agreement The insurance provided by this Coverage Form is contingent. We will pay all sums an insured legally must pay as damages because of bodily injury or property damage to which this insurance applies caused by an accident and resulting from the ownership maintenance or use of a covered auto. We will also pay all sums an insured legally must pay as a covered pollution cost or expense to which this insurance applies caused by an accident and resulting from the ownership maintenance or use of covered autos. However we will only pay for the covered pollution cost or expense if there is either bodily injury or property damage to which this insurance applies that is caused by the same accident. We have the right and duty to defend any insured against a suit asking for such damages or for a covered pollution cost or expense. However we have no duty to defend any insured against a suit seeking damages for bodily injury or property damage or a covered pollution cost or expense to which this insurance does not apply. We may investigate and settle any claim or suit as we consider appropriate. Our duty to defend or settle ends when the Contingent Auto Liability Coverage Form Limit of Insurance has been exhausted by payment of judgments or settlements. Subject to the settlement investigation and defense provisions Policy Period and Coverage Territory Conditions this insurance applies to claims made or suits brought worldwide. Supplementary Payments In addition to the Limit of Insurance we will pay for the insured 1. All expenses we incur. 2. Up to 2000 for cost of bail bonds including bonds for related traffic law violations required because of an accident we cover. We do not have to furnish these bonds. 3. The cost of bonds to release attachments in any suit against the insured we defend but only for bond amounts within our Limit of Insurance. 4. All reasonable expenses incurred by the insured at our request including actual loss of earnings up to 250 a day because of time off from work. 5. All court costs taxed against the insured in any suit against the insured we defend. 6. All interest on the full amount of any judgment that accrues after entry of the judgment in any suit against the insured we defend but our duty to pay interest ends when we have paid offered to pay or deposited in court the part of the judgment that is within our Limit of Insurance. IT7027 version date 08 2013 Page 1 of 14 Material reprinted in part with permission of ISO Properties Inc. K4F 2122016 | 2 |
These payments will not reduce the Limit of Insurance. C. Exclusions This insurance does not apply to any of the following 1. Expected Or Intended Injury Bodily injury or property damage expected or intended from the standpoint of the insured. Contractual Liability assumed under any contract or agreement. But this exclusion does not apply to liability for damages a. Assumed in a contract or agreement that is an insured contract provided the bodily injury or property damage occurs subsequent to the execution of the contract or agreement or b. That the insured would have in the absence of the contract or agreement. Workers Compensation and Similar Laws Any obligation for which the insured or the insured s insurer may be held liable under any workers compensation disability benefits or unemployment compensation law or any similar law. Employee Indemnification And Employer s Liability Bodily injury to a. An employee of the insured arising out of and in the course of 1 Employment by the insured or 2 Performing the duties related to the conduct of the insured s business or b. The spouse child parent brother or sister of that employee as a consequence of Paragraph a. above. This exclusion applies 1 Whether the insured may be liable as an employer or in any other capacity and 2 To any obligation to share damages with or repay someone else who must pay damages because of the injury. But this exclusion does not apply to bodily injury to domestic employees not entitled to workers compensation benefits or to liability assumed by the insured under an insured contract. For the purposes of this Coverage Form a domestic employee is a person engaged in household or domestic work performed principally in connection with a residence premises. Fellow Employee Bodily injury to any fellow employee of the insured arising out of and in the course of the fellow employee s employment or while performing duties related to the conduct of your business. Care Custody Or Control Property damage to or covered pollution cost or expense involving property owned or transported by the insured or in the insured s care custody or control. But this exclusion does not apply to liability assumed under a sidetrack agreement. IT7027 version date 08 2013 Page 2 of 14 Material reprinted in part with permission of ISO Properties Inc. K4F 2122016 | 2 |
7. Handling Of Property Bodily injury or property damage resulting from the handling of property a. Before it is moved from the place where it is accepted by the insured for movement into or onto the covered auto or b. After it is moved from the covered auto to the place where it is finally delivered by the insured. 8. Movement Of Property By Mechanical Device Bodily injury or property damage resulting from the movement of property by a mechanical device other than a hand truck unless the device is attached to the covered auto. 9. Operations Bodily injury or property damage arising out of the operation of a. Any equipment listed in Paragraphs 6.b. and 6.c. of the definition of mobile equipment or b. Machinery or equipment that is on attached to or part of a land vehicle that would qualify under the definition of mobile equipment if it were not subject to a compulsory or financial responsibility law or other motor vehicle insurance law where it is licensed or principally garaged. 10. Completed Operations Bodily injury or property damage arising out of your work after that work has been completed or abandoned. In this exclusion your work means a. Work or operations performed by you or on your behalf and b. Materials parts or equipment furnished in connection with such work or operations. Your work includes warranties or representations made at any time with respect to the fitness quality durability or performance of any of the items included in Paragraphs a. or b. above. Your work will be deemed completed at the earliest of the following times 1 When all of the work called for in your contract has been completed. 2 When all of the work to be done at the site has been completed if your contract calls for work at more than one site. 3 When that part of the work done at a job site has been put to its intended use by any person or organization other than another contractor or subcontractor working on the same project. Work that may need service maintenance correction repair or replacement but which is otherwise complete will be treated as completed. 11. Pollution Bodily injury or property damage arising out of the actual alleged or threatened discharge dispersal seepage migration release or escape of pollutants a. That are or that are contained in any property that is 1 Being transported or towed by handled or handled for movement into onto or from the covered auto 2 Otherwise in the course of transit by or on behalf of the insured or IT7027 version date 08 2013 Page 3 of 14 Material reprinted in part with permission of ISO Properties Inc. K4F 2122016 | 2 |
3 Being stored disposed of treated or processed in or upon the covered auto b. Before the pollutants or any property in which the pollutants are contained are moved from the place where they are accepted by the insured for movement into or onto the covered auto or c. After the pollutants or any property in which the pollutants are contained are moved from the covered auto to the place where they are finally delivered disposed of or abandoned by the insured. Paragraph a. above does not apply to fuels lubricants fluids exhaust gases or other similar pollutants that are needed for or result from the normal electrical hydraulic or mechanical functioning of the covered auto or its parts if 1 The pollutants escape seep migrate or are discharged dispersed or released directly from an auto part designed by its manufacturer to hold store receive or dispose of such pollutants and 2 The bodily injury property damage or covered pollution cost or expense does not arise out of the operation of any equipment listed in Paragraphs 6.b. and 6.c. of the definition of mobile equipment. Paragraphs b. and c. above of this exclusion do not apply to accidents that occur away from premises owned by or rented to an insured with respect to pollutants not in or upon a covered auto if 1 The pollutants or any property in which the pollutants are contained are upset overturned or damaged as a result of the maintenance or use of a covered auto and 2 The discharge dispersal seepage migration release or escape of the pollutants is caused directly by such upset overturn or damage. 12. War Bodily injury property damage or covered pollution cost or expense arising directly or indirectly out of a. War including undeclared or civil war b. Warlike action by a military force including action in hindering or defending against an actual or expected attack by any government sovereign or other authority using military personnel or other agents or c. Insurrection rebellion revolution usurped power or action taken by governmental authority in hindering or defending against any of these. 13. Racing Covered autos while used in any professional or organized racing or demolition contest or stunting activity or while practicing for such contest or activity. This insurance also does not apply while that covered auto is being prepared for such a contest or activity. 14. Nuclear Any injury damage expense cost loss liability or legal obligation arising out of nuclear. We shall have no duty or obligation to provide or pay for the investigation or defense of any suit excluded under nuclear. 15. Statutory Coverage Satisfaction of any mandatory insurance or financial responsibility requirement imposed by any statute ordinance or regulation in any jurisdiction. IT7027 version date 08 2013 Page 4 of 14 Material reprinted in part with permission of ISO Properties Inc. K4F 2122016 | 2 |
SECTION Il COVERED AUTOS The following are covered autos A. Owned Autos Only those autos you own and any trailers you do nt own while attached to power units you own. This includes those autos you acquire ownership of after the policy begins. B. Hired Autos Only those autos you lease hire rent or borrow. This does not include any auto you lease hire rent or borrow from any of your employees partners if you are a partnership members if you are a limited liability company or members of their households. C. Non owned Autos Only those autos you do not own lease hire rent or borrow that are used in connection with your business. This includes autos owned by your employees partners if you are a partnership members if you are a limited liability company or members of their households but only while used in your business or your personal affairs. D. Mobile Equipment Subject to Compulsory or Financial Responsibility Or Other Motor Vehicle Law Only Only those autos that are land vehicles and that would qualify under the definition of mobile equipment under this policy if they were not subject to a compulsory or financial responsibility law or other motor vehicle insurance law where they are licensed or principally garaged. E. Newly Acquired Autos Those autos that you acquire of the types described in Paragraphs A. B. C. and D. above for the remainder of the Policy Period. F. Other Covered Autos The following types of vehicles are also covered autos for Liability Coverage 1. Trailers with a load capacity of 2000 pounds or less designed primarily for travel on public roads. 2. Mobile equipment while being carried or towed by a covered auto. 3. Any auto you do not own while used with the permission of its owner as a temporary substitute for a covered auto you own that is out of service because of its a. Breakdown b. Repair c. Servicing d. Lossor e. Destruction. SECTION Ill WHO IS AN INSURED The following are insureds A. You for any covered auto. IT7027 version date 08 2013 Page 5 of 14 Material reprinted in part with permission of ISO Properties Inc. K4F 2122016 | 2 |
B. Anyone else while using with your permission a covered auto you own hire or borrow except 1. The owner or anyone else from whom you hire or borrow a covered auto. This exception does not apply if the covered auto is a trailer connected to a covered auto you own. 2. Your employee if the covered auto is owned by that employee or a member of his or her household. 3. Someone using a covered auto while he or she is working in a business of selling servicing repairing parking or storing autos unless that business is yours. 4. Anyone other than your employees partners if you are a partnership members if you are a limited liability company or a lessee or borrower or any of their employees while moving property to or from a covered auto. 5. A partner if you are a partnership or a member if you are a limited liability company for a covered auto owned by him or her or a member of his or her household. C. Anyone liable for the conduct of an insured described above but only to the extent of that liability. SECTION IV LIMIT OF INSURANCE Regardless of the number of covered autos insureds premiums paid claims made or vehicles involved in the accident the most we will pay for the total of all damages and covered pollution cost or expense combined resulting from any one accident is the Limit of Insurance for Liability Coverage shown in the Declarations. All bodily injury property damage and covered pollution cost or expense resulting from continuous or repeated exposure to substantially the same conditions will be considered as resulting from one accident. No one will be entitled to receive duplicate payments for the same elements of loss under this Coverage Form and any Medical Payments Coverage Endorsement attached to this Coverage Form. SECTION V AUTO CONDITIONS The following conditions apply in addition to the Common Policy Conditions A. Duties In The Event Of Accident Claim Suit Or Loss We have no duty to provide coverage under this policy unless there has been full compliance with the following duties 1. In the event of accident claim suit or loss you must give us or our authorized representative prompt notice of the accident or loss. Include a. How when and where the accident or loss occurred b. The insured s name and address and c. To the extent possible the names and addresses of any injured persons and witnesses. 2. Additionally you and any other involved insured must a. Assume no obligation make no payment or incur no expense without our consent except at the insured s own cost. b. Immediately send us copies of any request demand order notice summons or legal paper received concerning the claim or suit. c. Cooperate with us in the investigation or settlement of the claim or defense against the suit. IT7027 version date 08 2013 Page 6 of 14 Material reprinted in part with permission of ISO Properties Inc. K4F 2122016 | 2 |
d. Authorize us to obtain medical records or other pertinent information. e. Submit to examination at our expense by physicians of our choice as often as we reasonably require. B. Legal Action Against Us No one may bring a legal action against us under this Coverage Form until 1. There has been full compliance with all the terms of this Coverage Form and 2. We agree in writing that the insured has an obligation to pay or until the amount of that obligation has finally been determined by judgment after trial. No one has the right under this policy to bring us into an action to determine the insured s liability. C. Transfer Of Rights Of Recovery Against Others To Us If any person or organization to or for whom we make payment under this Coverage Form has rights to recover damages from another those rights are transferred to us. That person or organization must do everything necessary to secure our rights and must do nothing after accident or loss to impair them. D. Other Insurance 1. Excess Insurance The insurance provided by this Coverage Form is excess. This insurance is excess over any other insurance whether primary excess contingent or on any other basis that is auto coverage including but not limited to any auto coverage required by law regulation or other governmental authority. Our Limits of Insurance will be reduced by the amount of such other insurance including any deductibles or self insured retention amounts. The insurance provided by this Coverage Form will not act as a substitute for any auto coverage required by law regulation or other governmental authority. Failure to maintain such coverage required by law regulation or other governmental authority will not invalidate this insurance. However this insurance will apply as if the coverage required by law regulation or other governmental authority was in full force and effect. 2. Primary Insurance The insurance provided by this Coverage Form will take the place of primary insurance when the insured has no primary insurance provided that such primary insurance is not required by law regulation or other governmental authority. E. Maintenance of Underlying Insurance 1. The insured must have and maintain auto insurance required by law regulation or other governmental authority in full force and effect during the policy period except for reduction of aggregate limits due to payments of claims judgments or settiements. 2. The following additional provisions apply with respect to Owned Autos or Hired Autos as those terms are described in SECTION Il COVERED AUTOS A. Owned Autos and B. Hired Autos above that you lease for a continuous period of more than thirty 30 consecutive days a. The insured must have and maintain primary auto insurance herein referred to as underlying insurance in full force and effect throughout the policy period with minimum limits 1 As required by applicable motor vehicle insurance law andor financial responsibility law or IT7027 version date 08 2013 Page 7 of 14 Material reprinted in part with permission of ISO Properties Inc. K4F 2122016 | 2 |
2 Equivalent to 25.000 each accident Combined Single Limit for bodily injury and property damage whichever is higher. b. The coverage provided by this Coverage Form is excess. Our Limits of Insurance will be reduced by the amount of such underlying insurance including any deductibles or self insured retention amounts. c. If the insured fails to have and maintain such underlying insurance as shown above the coverage provided herein will apply as if such underlying insurance was in full force and effect. Premium Audit The estimated premium for this Coverage Form is based on the exposures you told us you would have when this policy began. We will compute the final premium due when we determine your actual exposures. The estimated total premium will be credited against the final premium due and the first Named Insured will be billed for the balance if any. The due date for the final premium or retrospective premium is the date shown as the due date on the bill. If the estimated total premium exceeds the final premium due the first Named Insured will get a refund. If this policy is issued for more than one year the premium for this Coverage Form will be computed annually based on our rates or premiums in effect at the beginning of each year of the policy.. Policy Period Coverage Territory Under this Coverage Form we cover accidents and losses occurring 1. During the Policy Period shown in the Declarations and 2. Within the coverage territory for COMMERCIAL AUTO LIABILITY COVERAGE shown in the Declarations. 3. We also cover accidents involving a covered auto while being transported between places which are in the coverage territory.. Two Or More Coverage Forms Or Policies Issued By Us If this Coverage Form and any other Coverage Form or policy issued to you by us or any company affiliated with us apply to the same accident the aggregate maximum Limit of Insurance under all the Coverage Forms or policies shall not exceed the highest applicable Limit of Insurance under any one Coverage Form or policy. This condition does not apply to any Coverage Form or policy issued by us or an affiliated company specifically to apply as excess insurance over this Coverage Form. Knowledge Of An Accident Knowledge of an accident by any of your agents servants or employees shall not constitute knowledge by you unless one of your executive officers or anyone responsible for administering your insurance program has received notice from the agent servant or employee. Expanded Coverage Territory and Currency All payments or reimbursements we make for damages because of judgments or settlements will be made in U.S. currency at the prevailing exchange rate at the time the insured became legally obligated to pay such sums. All payments or reimbursements we make for expenses under Supplementary Payments will be made in U.S. currency at the prevailing exchange rate at the time the expenses were incurred. IT7027 version date 08 2013 Page 8 of 14 Material reprinted in part with permission of ISO Properties Inc. K4F 2122016 | 2 |
SECTION VI DEFINITIONS A Accident includes continuous or repeated exposure to the same conditions resulting in bodily injury or property damage. B. Auto means 1. Aland motor vehicle trailer or semi trailer designed for travel on public roads or 2. Any other land vehicle that is subject to a compulsory or financial responsibility law or other motor vehicle insurance law where it is licensed or principally garaged. However auto does not include mobile equipment. C. Bodily injury means bodily injury sickness or disease sustained by a person including death resulting from any of these. D. Contingent means insurance issued to apply to claims or suits arising from accidents outside the country in which the insurance was issued. Contingent insurance takes the place of primary insurance when the insured has no primary insurance which applies. Contingent insurance will pay only the amount by which its limit exceeds the limits of any primary insurance including primary insurance issued on an excess basis which applies. When this insurance is contingent we have the right but not the duty to defend. If no primary insurance applies then we have the duty to defend. E. Coverage Territory means Coverage Territory for Liability Coverages shown in the Declarations. The coverage territory also includes 1. International waters or airspace provided the loss to or accident involving a covered auto was during the course of transportation from one place to another when both places are not within the United States of America including its territories and possessions Puerto Rico or Canada 2. The United States of America including its territories and possessions Puerto Rico or Canada if the insured s responsibility to pay damages is determined in a suit on the merits in any country other than the United States of America including its territories or possessions Puerto Rico or Canada. F. Covered pollution cost or expense means any cost or expense arising out of 1. Any request demand order or statutory or regulatory requirement that any insured or others test for monitor clean up remove contain treat detoxify or neutralize or in any way respond to or assess the effects of pollutants or 2. Any claim or suit by or on behalf of a governmental authority for damages because of testing for monitoring cleaning up removing containing treating detoxifying or neutralizing or in any way responding to or assessing the effects of pollutants. Covered pollution cost or expense does not include any cost or expense arising out of the actual alleged or threatened discharge dispersal seepage migration release or escape of pollutants a. Thatare or that are contained in any property that is 1 Being transported or towed by handled or handled for movement into onto or from the covered auto 2 Otherwise in the course of transit by or on behalf of the insured IT7027 version date 08 2013 Page 9 of 14 Material reprinted in part with permission of ISO Properties Inc. K4F 2122016 | 2 |
3 Being stored disposed of treated or processed in or upon the covered auto b. Before the pollutants or any property in which the pollutants are contained are moved from the place where they are accepted by the insured for movement into or onto the covered auto or c. After the pollutants or any property in which the pollutants are contained are moved from the covered auto to the place where they are finally delivered disposed of or abandoned by the insured. Paragraph a. above does not apply to fuels lubricants fluids exhaust gases or other similar pollutants that are needed for or result from the normal electrical hydraulic or mechanical functioning of the covered auto or its parts if 1 The pollutants escape seep migrate or are discharged dispersed or released directly from an auto part designed by its manufacturer to hold store receive or dispose of such pollutants and 2 The bodily injury property damage or covered pollution cost or expense does not arise out of the operation of any equipment listed in Paragraphs 6.b. or 6.c. of the definition of mobile equipment. Paragraphs b. and c. above do not apply to accidents that occur away from premises owned by or rented to an insured with respect to pollutants not in or upon a covered auto if 1 The pollutants or any property in which the pollutants are contained are upset overturned or damaged as a result of the maintenance or use of a covered auto and 2 The discharge dispersal seepage migration release or escape of the pollutants is caused directly by such upset overturn or damage. G. Employee includes a leased worker. Employee does not include a temporary worker. H. Insured means any person or organization qualifying as an insured in the Who Is An Insured provision of the applicable coverage. Except with respect to the Limit of Insurance the coverage afforded applies separately to each insured who is seeking coverage or against whom a claim or suit is brought. I. Insured contract means 1. Alease of premises 2. A sidetrack agreement 3. Any easement or license agreement except in connection with construction or demolition operations on or within 50 feet of a railroad 4. An obligation as required by ordinance to indemnify a municipality except in connection with work for a municipality 5. That part of any other contract or agreement pertaining to your business including an indemnification of a municipality in connection with work performed for a municipality under which you assume the tort liability of another to pay for bodily injury or property damage to a third party or organization. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement 6. That part of any contract or agreement entered into as part of your business pertaining to the rental or lease by you or any of your employees of any auto. However such contract or agreement shall not be considered an insured contract to the extent that it obligates you or any IT7027 version date 08 2013 Page 10 of 14 Material reprinted in part with permission of ISO Properties Inc. K4F 2122016 | 2 |
of your employees to pay for property damage to any auto rented or leased by you or any of your employees. An insured contract does not include that part of any contract or agreement a. That indemnifies a railroad for bodily injury or property damage arising out of construction or demolition operations within 50 feet of any railroad property and affecting any railroad bridge or trestle tracks roadbeds tunnel underpass or crossing or b. That pertains to the loan lease or rental of an auto to you or any of your employees if the auto is loaned leased or rented with a driver or c. That holds a person or organization engaged in the business of transporting property by auto for hire harmless for your use of a covered auto over a route or territory that person or organization is authorized to serve by public authority. J. Leased worker means a person leased to you by a labor leasing firm under an agreement between you and the labor leasing firm to perform duties related to the conduct of your business. Leased worker does not include a temporary worker. K. Loss means direct and accidental loss or damage. Mobile equipment means any of the following types of land vehicles including any attached machinery or equipment 1. Bulldozers farm machinery forklifts and other vehicles designed for use principally off public roads 2. Vehicles maintained for use solely on or next to premises you own or rent 3. Vehicles that travel on crawler treads 4. Vehicles whether self propelled or not maintained primarily to provide mobility to permanently mounted a. Power cranes shovels loaders diggers or drills or b. Road construction or resurfacing equipment such as graders scrapers or rollers. 5. Vehicles not described in Paragraphs 1. 2. 3. or 4. above that are not self propelled and are maintained primarily to provide mobility to permanently attached equipment of the following types a. Air compressors pumps and generators including spraying welding building cleaning geophysical exploration lighting and well servicing equipment or b. Cherry pickers and similar devices used to raise or lower workers. 6. Vehicles not described in Paragraphs 1. 2. 3. or 4. above maintained primarily for purposes other than the transportation of persons or cargo. However self propelled vehicles with the following types of permanently attached equipment are not mobile equipment but will be considered autos a. Equipment designed primarily for 1 Snow removal 2 Road maintenance but not construction or resurfacing or 3 Street cleaning b. Cherry pickers and similar devices mounted on automobile or truck chassis and used to raise or lower workers and IT7027 version date 08 2013 Page 11 of 14 K4F 2122016 Material reprinted in part with permission of ISO Properties Inc. K4F 2122016 | 2 |
c. Air compressors pumps and generators including spraying welding building cleaning geophysical exploration lighting or well servicing equipment. However mobile equipment does not include land vehicles that are subject to a compulsory or financial responsibility law or other motor vehicle insurance law where it is licensed or principally garaged. Land vehicles subject to a compulsory or financial responsibility law or other motor vehicle insurance law are considered autos. M. Nuclear means 1. Under any Liability Coverage to bodily injury or property damage a. With respect to which any insured under the policy who is also an insured under a nuclear energy liability Policy issued by Nuclear Energy Liability Insurance Association Mutual Atomic Energy Liability Underwriters Nuclear Insurance Association of Canada or any other similar nuclear energy liability insurance underwriting association or organization or any of their successors or would be an insured under any such policy but for its termination upon exhaustion of its limit of liability or b. Resulting from the hazardous properties of nuclear material and with respect to which a any person or organization is required to maintain financial protection pursuant to the Atomic Energy Act of 1954 or any other law or regulation requiring the insured to maintain such financial protection or any law amendatory thereof or b the insured is or had this policy not been issued would be entitled to indemnity from the United States of America or any other country or any agency thereof under any agreement entered into by the United States of America or any other country or any agency thereof with any person or organization. 2. Under any Medical Payments coverage to expenses incurred with respect to bodily injury resulting from the hazardous properties of nuclear material and arising out of the operation of a nuclear facility by any person or organization. 3. Under any Liability Coverage to bodily injury or property damage resulting from the hazardous properties of nuclear material if a. The nuclear material a is at any nuclear facility owned by or operated by or on behalf of an insured or b has been discharged or dispersed therefrom b. The nuclear material is contained in spent fuel or waste at any time possessed handled used processed stored transported or disposed of by or on behalf of any insured or c. The bodily injury or property damage arises out of the furnishing by an insured of services materials parts or equipment in connection with the planning construction maintenance operation or use of any nuclear facility. As used in this definition of nuclear a. Hazardous properties includes radioactive toxic or explosive properties b. Nuclear material means source material special nuclear material or by product material c. Source material special nuclear material and by product material have the meanings given them in Atomic Energy Act of 1954 or any law amendatory thereof d. Spent fuel means any fuel element or fuel component solid or liquid which has been used or exposed to radiation in a nuclear reactor e. Waste means any waste material 1 containing by product material other than the tailings or wastes produced by the extraction or concentration of uranium or thorium from any ore processed primarily for its source material content and 2 resulting from the operation by any person or organization of any nuclear facility included under Paragraph 1 or 2 of the definition of nuclear facility IT7027 version date 08 2013 Page 12 of 14 K4F 2122016 Material reprinted in part with permission of ISO Properties Inc. K4F 2122016 | 2 |
f. Nuclear facility means 1 Any nuclear reactor 2 Any equipment or device designed or used for a separating the isotopes of uranium or plutonium b processing or utilizing spent fuel or c handling processing or packaging wastes 3 Any equipment or device used for the processing fabricating or alloying of special nuclear material if at any time the total amount of such material in the custody of the insured at the premises where such equipment or device is located consists of or contains more than 25 grams of plutonium or uranium 233 or any combination thereof or more than 250 grams of uranium 235 4 Any structure basin excavation premises or place prepared or used for storage or disposal of waste and includes the site on which any of the foregoing is located all operations conducted on such site and all premises used for such operations g. Nuclear reactor means any apparatus designed or used to sustain nuclear fission in a self supporting chain reaction or to contain a critical mass of fissionable material h. Property damage includes all forms of radioactive contamination of property. Pollutants means any solid liquid gaseous or thermal irritant or contaminant including smoke vapor soot fumes acids alkalis chemicals waste biological material bacteria virus and intangibles which negatively affect the health and welfare of people disrupt ecological balance or desecrate the environment and negatively impact plants and non human species. Waste means any substance or material that a is left over or no longer in use or discarded b is to be reclaimed recycled or reconditioned or c has been removed treated stored or disposed of as part of any environmental remediation clean up or response effort. Waste includes but is not limited to animal human medical and biological waste even if used or intended for use as fertilizer or for any other use. Primary means insurance issued to respond prior to other insurance to claims or suits brought in the country in which such insurance was issued. Primary insurance may include insurance for claims or suits arising from occurrences which take place outside the country in which such insurance was issued. Property damage means damage to or loss of use of tangible property. Suit means a civil proceeding in which 1. Damages because of bodily injury or property damage or 2. Acovered pollution cost or expense to which this insurance applies are alleged. Suit includes a. An arbitration proceeding in which such damages or covered pollution costs or expenses are claimed and to which the insured must submit or does submit with our consent or b. Any other alternative dispute resolution proceeding in which such damages or covered pollution costs or expenses are claimed and to which the insured submits with our consent. IT7027 version date 08 2013 Page 13 of 14 Material reprinted in part with permission of ISO Properties Inc. K4F 2122016 | 2 |
Temporary worker means a person who is furnished to you to substitute for a permanent employee on leave or to meet seasonal or short term workload conditions. Trailer includes a semi trailer. Workers Compensation and Similar Laws means any workers compensation law occupational disease law or any other legal authority imposing liability for or requiring payment of compensation benefits medical care or loss of wages to an employee by reason of bodily injury or disease arising during the course of employment regardless of whether such payment is required to be made by the employer or any governmental entity. IT7027 version date 08 2013 Page 14 of 14 Material reprinted in part with permission of ISO Properties Inc. K4F 2122016 | 2 |
aceusa EMPLOYERS RESPONSIBILITY COVERAGES WITH EXECUTIVE ASSISTANCE THIS INSURANCE MAY NOT BE OFFERED IN SATISFACTION OF THE INSURANCE REQUIREMENTS OF ANY WORKERS COMPENSATION LAW ANYWHERE. VOLUNTARY COMPENSATION COVERAGE Voluntary compensation coverage applies when you make a claim for bodily injury by accident bodily injury by disease or bodily injury by endemic disease. The bodily injury must be injury to your employee and must arise out of and in the course of employment by you. Bodily injury includes resulting death. 1. Bodily injury by accident must occur during the Policy Period. 2. Bodily injury by disease must be caused or aggravated by the conditions of your employment. The employee s last day of last exposure to the conditions causing or aggravating such bodily injury by disease must occur during the Policy Period. 3. Bodily injury by endemic disease must be caused by disease which your employee may reasonably be thought to have contracted by being in a place as a result of your employment. The employee must have been in a place where the disease contracted is known to occur. The time the employee was in the place where the disease occurs must have been within the Policy Period. The employee s last day of last exposure to the conditions causing or aggravating such bodily injury by disease must occur during the Policy Period. We will adjust the claim with the employee by applying the workers compensation law of the state you choose when you make the claim. The state whose law you choose must be one which is shown in the Declarations. The workplace of the employee must be within the coverage territory. We Will Pay Benefits We will pay promptly the benefits which would be required of you by the workers compensation law of the state you choose when making the claim. The state you choose must be one which is shown in the Declarations for the following 1. North Americans meaning employees who are citizens or legal permanent residents of the United States including its territories and possessions and Puerto Rico 2. Third Country Nationals meaning employees who are not citizens of the country of their workplace and who are not described in 1. above and 3. Local Nationals meaning employees while traveling outside the country of their workplace and who are citizens of the country of their workplace but who are not described in 1. above. If State of Hire appears after the words North Americans in the Declarations for Voluntary Compensation then with respect to employees for whom you wish to provide the benefits of a state of the United States of America including its territories and possessions or Puerto Rico but who were not hired in any of those places the benefits will be K4F 2122016 IT1084 version date 09 2008 Page 1 of 15 | 2 |
1. those of the state to which you agreed with the employee prior to the accident or the discovery of the disease or 2. if no state was agreed with the employee prior to the accident or the discovery of the disease the benefits of the specific state shown in the Declarations for North Americans as an alternative to state of hire or 3. if no state was agreed with the employee prior to the accident or the discovery of the disease and no specific state is shown above for North Americans the benefits of the state shown in the address of the insured on the first page of the Declarations for this policy. Payments You Must Make You are responsible for any payments in excess of the benefits regularly provided by the workers compensation law including those required because 1. of your serious and willful misconduct 2. you knowingly employ an employee in violation of law 3. you fail to comply with a health or safety law or regulation or 4. you discharge coerce or otherwise discriminate against any employee in violation of the workers compensation law. If we make any payments in excess of the benefits regularly provided by the workers compensation law on your behalf you will reimburse us promptly. Before We Pay Before we pay benefits to the persons for whom you have made claims they must 1. Release you and us in writing of all responsibility for the injury or death if we so request 2. Transfer to us their right to recover from others who may be responsible for the injury or death and 3. Cooperate with us and do everything necessary to enable us to enforce the right to recover from others. If the persons for whom you have made claims under this coverage fail to do those things our duty to pay ends at once. If they claim damages from you or from us for the injury or death our duty to pay ends at once. Recovery From Others If we make a recovery from others we will keep an amount equal to our expenses of recovery and the benefits we paid. We will pay the balance to the persons entitled to it. If the persons who receive the benefits of this insurance make a recovery from others they must reimburse us for the benefits we paid them. EXECUTIVE ASSISTANCE SERVICES When an employee that is covered under this coverage part becomes injured or ill while traveling on your business within the coverage territory Executive Assistance Services are available. We will provide your employee subject to the Limits of Insurance shown in the Declarations under Il. Executive Assistance Services Medical Assistance Services with the services listed below. Executive Assistance Services are Medical Assistance Personal Assistance Travel Assistance and Security Assistance as described herein. K4F 2122016 IT1084 version date 09 2008 Page 2 of 15 | 2 |
Executive Assistance is serviced by a third party provider of the Medical Assistance Personal Assistance Travel Assistance and Security Assistance services described in this section. Executive Assistance Services are available to you your expatriate employees and employees engaged in temporary travel including their accompanying spouse children or other companions engaged in temporary travel. For Executive Assistance Services the definition of employee is extended to include accompanying spouse children or other companions. Employees may contact the service provider at any hour on any day. For Executive Assistance Services Temporary Travel includes personal travel but only if such personal travel does not exceed a total of fourteen consecutive days and is incidental to travel on your business outside of the country of an employee s workplace. The service provider is staffed with trained multi lingual personnel including doctors on round the clock call for emergency medical consultation and assistance as described in these Executive Assistance Services. This center handles requests for referrals to English speaking doctors and specialists as well as all aspects of coordinating an emergency medical evacuation. Information about Executive Assistance Services as well as access to the online Security Assistance services listed above will be available through a password protected website address www.aceExecutiveAssistance.com. The Login Name and Password for this website is provided to you under separate cover in your policy packet. Security assistance will be one of several information services available through this website. There are no restrictions to the number of times an insured may access this website including the Security information services. Executive Assistance wallet cards and passport stickers also will be available to insureds online through this website as PDF documents that can be downloaded and printed at the convenience of ACE policy holders. Medical Assistance Services We will not pay more for all Medical Assistance Services expense in any one policy year than the amount shown in the Declarations as the policy limit for Medical Assistance Services regardless of the number of employees to whom services were rendered. If we incur expenses for Medical Assistance Services in any one policy year in excess of the policy limit you agree to reimburse us or our designee for the amount in excess of the policy limit. Al services and payments must be arranged and pre approved by the service provider. Evacuations Repatriations must be ordered by a legally licensed physician and approved by the service provider s designated physician to certify that the severity of the employees injury or sickness warrants an emergency evacuation repatriation. All transportation arrangements must be by the most direct and economical route possible. In the event you are seriously il or injured and can not call you must contact the service provider as soon as you are able. Hospital Admission Deposit We will either guarantee the payment of or wire any required emergency hospital admission deposit up to US 10000. You or your employee will repay any such deposit to us within 45 days without interest. If you fail to repay to us such deposit in the time allowed or we are required to pay on our guarantee then such money becomes a service rendered and we have the additional rights set out under the heading Transfer of Rights of Recovery against Others to Us. Medical Monitoring The service provider will monitor the employee s condition when hospitalized abroad and will use best efforts to report regularly the employee s condition to a person designated by the employee. K4F 2122016 IT1084 version date 09 2008 Page 3 of 15 | 2 |
Dispatch of a Doctor or Specialist When the service provider determines based on information available to them that an employee s condition can not be adequately assessed to evaluate the need for evacuation the service provider will dispatch a doctor or specialist to the employee s location. We will pay the cost of the doctor s or specialist s travel to the employee s location but we will not pay the cost of any medical services rendered by the doctor or specialist at the location. Medical Expenses are not covered by Executive Assistance and should be submitted to the health carrier or if work related submitted to the Workers Compensation carrier or similar carrier. Emergency Medical Evacuation When the service provider determines adequate medical facilities are not available locally we will arrange and pay for emergency medical evacuation under medical supervision if necessary to the nearest location with adequate facilities. Our obligation is limited to the limits of liability shown in the declarations page. The service provider will arrange and we will pay the cost for one family member or other traveling companion to continue to accompany the employee during evacuation if it is reasonably possible for that person to accompany the employee. Our obligation is limited to the cost of the airfare and an incidental expense maximum of 300. per day and 5000 Maximum for any one occurrence. Employee and any accompanying family member or other traveling companion may be required to release us or a third party assistance provider from liability during emergency evacuation. Repatriation If the service provider determines based on information available to them that it is medically necessary to repatriate the employee to a facility which is in the country of residence of the employee or a location in the country of which the employee is a citizen following stabilization we will arrange and will pay for repatriation under medical supervision if necessary. The service provider will arrange and we will pay the cost of one family member or other traveling companion to continue to accompany the employee during repatriation if it is reasonably possible for that person to accompany the employee. Our obligation is limited to the cost of the airfare and an incidental travel expense of a maximum of 300. per day and Maximum for any one occurrence of 5000. Employee and any accompanying family member or other traveling companion may be required to release us or a third party assistance provider from liability during repatriation. Our obligation is limited to the provision of one 1 repatriation attributable to any single medical condition of an employee. Repatriation of Mortal Remains In the event of an employee s death while traveling the service provider will render every assistance possible to obtain necessary clearances and arrange for the return of the mortal remains in an appropriate transportation container to a location which is consistent with the known reasonable wishes of the employee or of the employee s family. We will pay reasonable expenses associated with such return including the cost of embalming to meet any applicable requirements. We will also pay the cost of one family member or other traveling companion to continue to accompany the mortal remains of the deceased employee during repatriation if it is reasonably possible for that person to accompany the remains. Our obligation is limited to the cost of the airfare and an incidental travel expense of a maximum of 300. per day and a Maximum for any one occurrence of 5000. K4F 2122016 IT1084 version date 09 2008 Page 4 of 15 | 2 |
Personal Assistance Pre Trip Medical Referral Information The service provider will provide pre trip referral information to employees regarding countries and regions to be visited including local multi lingual doctors andor addresses and phone numbers for hospitals. Emergency Medication Should an employee require prescription medication that is not available locally the service provider will make arrangements for the transportation of such medication when possible and legally permissible to the employee upon the request of the prescribing physician. The employee is responsible for the cost of medication and the transportation. Embassy and Consular Information The service provider will provide employees with contact information for embassies and consulates worldwide. Lost Document Assistance The service provider will assist with obtaining replacements if an employee loses important travel documents while traveling including passport and credit cards. We will not pay the cost of obtaining such replacements. Emergency Message Transmission The service provider will make reasonable efforts to receive and transmit emergency messages for an employee to one family member andor employer. Emergency Cash Advance We will whenever possible provide employees with a cash advance of up to 1000 in local currency for emergencies. You or your employee will repay any such emergency cash advance to us within 45 days without interest. If you or your employee fail to repay to us such advance then such money becomes a service rendered and we have the additional rights set out under the heading Transfer of Rights of Recovery against Others to Us. Legal Access The service provider will provide employees with an introduction to local attorneys. Assistance will also be provided in obtaining bail bonds in those areas where such bonds are customarily issued. Employee is responsible for contracted legal fees. Translations Interpreters The service provider will provide personal emergency translation services as well as referrals to interpreter services. When personal presence or other customized interpreter services are required the employee will be responsible to pay locally the cost of such interpreter services. Benefits Verification and Claims Assistance The service provider will assist employees in verifying their medical insurance benefits when hospitalized overseas and we will assist in coordinating overseas claims procedures with their health insurance and any applicable workers compensation insurance and as you direct. K4F 2122016 IT1084 version date 09 2008 Page 5 of 15 | 2 |
Travel Assistance Emergency Family Travel Arrangements The service provider will coordinate emergency travel arrangements for family members who need to join a hospitalized employee or to accompany the mortal remains of a deceased employee. The costs of travel services are the responsibility of the travelers. Return of Traveling Companion Dependents When the service provider hospitalizes or evacuates an employee and a traveling companion s air ticket is no longer usable The service provider will arrange but not pay the cost of one way air transportation for the companion to the original departure point or to their place of residence. At the request of the employee the service provider will arrange but not pay the cost of qualified attendants to accompany the return of traveling companions dependents. Return of Vehicle In the event of an employee s hospitalization or medical evacuation the service provider will arrange but not pay the cost to have the employee s unattended vehicle returned to the rental agency or the employee s current principal residence. Concierge Services As a benefit to the employees the service provider will offer a suite of services that assist in making arrangements or purchases that are useful to employees traveling outside of their country of residence. All costs associated with the purchase and or provision of the concierge services will be the sole responsibility of the employees. Where available Concierge Services will include A. Destination profiles The service provider shall provide information on every country in the world and over 200 cities worldwide including information on local entertainment suggested itineraries and health advisories. B. Epicurian needs The service provider shall arrange the delivery of specialized foods and beverages to the employee s home or office including gourmet food and fine wine. C. Event ticketing The service provider shall arrange for tickets to sporting events theater or concert event worldwide as long as the tickets are available for purchase. D. Floral Services The service provider shall arrange for the purchase and shipment flowers and gift baskets to friends family members and business associates. E. Tee time reservations The service provider shall provide referrals to golf courses and tee times at golf courses around the world. F. Hotel accommodations The service provider shall offer recommendations on hotels worldwide and book reservations if requested by the employees. G. Meet and greet services The service provider shall arrange the pick up of friends family members or business associates at airports or other common carrier destinations by limousine personnel. H. Personalized retail shopping assistance The service provider shall arrange for the purchase selected retail items at the employees request and expense. K4F 2122016 IT1084 version date 09 2008 Page 6 of 15 | 2 |
I. Pre trip assistance The service provider shall provide information on travel destinations city profiles special events ATM locations currency exchange rates immunization and passport requirements and related services. J. Procurement of hard to find items The service provider shall use its best efforts to arrange for an obscure or exotic item at the employees request. K. Restaurant referrals and reservations The service provider shall provide the employees with information on restaurants worldwide and will book reservations if requested. L. Rental car reservations The service provider shall arrange for worldwide reservations through most major rental car agencies. M. Commercial airline reservations The service provider shall arrange for air travel accommodations to destinations worldwide on behalf of the employees. SECURITY ASSISTANCE Travel Security Information We will provide the policy holder with access to the online Security Assistance services through www.aceExecutiveAssistance.com. Policy holder employees can select Information at a region country or city level to access detailed Travel Security Information reports regarding threats posed in a particular city or country by criminal or terrorist activities or political and civil unrest and other factors affecting travel in cities throughout the world. These reports will include an overall security rating across 6 key categories security alerts the latest Security Health and Exit Entry information key local contact numbers and a map. Emergency Political Repatriation and Relocation We will reimburse you or your employee for the Insured Losses arising from an Insured Event for Emergency Political Repatriation or Emergency Relocation incurred by you or your employee. The most we will reimburse is 2500 Per Employee per Insured Event for Emergency Political Repatriation and 2500 Per Employee per Insured Event for Emergency Relocation subject to a policy limit of 10000. regardless of the number of Insured Events. This extension is subject to the following additional definitions Insured Event shall mean the Emergency Political Repatriation or Emergency Relocation of an Employee which takes place within the Coverage Territory. Policy Limit shall mean the most we will pay under this policy. Emergency Political Repatriation shall be repatriation arising from a. Officials of the Resident Country issuing for reasons other than medical a recommendation that categories of persons which include employees should leave the country in which the employee is a temporary resident or b. An employee being expelled or declared persona non grata on the written authority of the recognized government of the country in which the employee is a temporary resident or c. The complete seizure confiscation or expropriation of property plant or equipment of the Insured by the authority of the recognized government of the country in which the employee is a temporary resident. K4F 2122016 IT1084 version date 09 2008 Page 7 of 15 | 2 |
Emergency Relocation shall be the return of an employee who has been subject of an Emergency Political Repatriation to the country from which the employee was expatriated. Repatriation for this coverage shall be the return of an employee to the employee s resident country. Resident Country shall be the country where the employee is a national. Insured Losses shall mean a. d. Transportation costs incurred by you or your employee for Emergency Political Repatriation to the employee s resident country or to the nearest place of safety outside the country where the insured event takes place. Reasonable accommodation costs incurred by you or your employee while the subject of Emergency Political Repatriation for a maximum period of seven days. Economy class transportation costs incurred by you or your employee on any licensed common carrier from a published timetable for Emergency Political Relocation of the employee and The Fees and expenses of the contracted security provider. Insured Losses shall not include however a. Costs fees or expenses incurred by you or your employee for Emergency Political Repatriation or Emergency Political Relocation as a result of a violation by you or your employee of the laws or regulations of the country in which the Insured Event takes place Costs fees or expenses incurred by you or your employee for Emergency Political Repatriation or Emergency Political Relocation as a result of the failure of you or your employee to properly procure or maintain any immigration work residence or similar visas permits or other documentation in the country in which the insured event takes place Costs fees or expenses incurred by you or your employee for emergency political repatriation or emergency political relocation from a debt insolvency commercial failure repossession of property by a titleholder mortgagee lien holder or other financial clause Costs fees or expenses incurred by you or your employee for emergency political repatriation or emergency political relocation for the failure to honor any contractual obligation or bond or obey any condition of a license Costs fees or expenses incurred for emergency political repatriation or emergency political relocation by nationals of the country in which the insured event takes place or Costs fees or expenses for emergency political repatriation or emergency political relocation caused by or arising out of natural disasters including but not limited to i. Earthquake flood fire volcanic eruption or windstorm ii. lonizing radiation or contamination by radioactivity from any irradiated nuclear fuel or from any nuclear waste from the combustion of nuclear fuel or ii. The Radioactive toxic explosive or other hazardous properties of any nuclear assembly or nuclear components thereof. K4F 2122016 IT1084 version date 09 2008 Page 8 of 15 | 2 |
Coverage Territory for Emergency Political Repatriation or Emergency Relocation Anywhere in the World but Excluding 1. the United States of America including its territories and possessions and Puerto Rico 2. any country or jurisdiction which is the subject of trade or economic sanctions imposed by the laws or regulations of the United States of America Exclusions We will not be responsible for the cost of services arising from Service provided outside the policy period if before the end of the policy period we have begun to assist an employee with any of the services described under the heading Medical Assistance Services we will continue to provide those services for up to seven days from the end of the policy period Services rendered without our authorization andor intervention but we will pay the cost if any which we estimate we would have incurred to provide evacuation andor repatriation to any employee who obtained such services without our authorization andor intervention. Services provided for which no charge is normally made Expenses incurred if the original or ancillary purpose of the employee s trip is to obtain medical treatment Intentionally self inflicted injuries suicide or any attempt thereof regardless of mental condition Service in the Armed Forces of any country Use of any drug unless prescribed by a physician The commission of or attempt to commit an unlawful act Routine or minor medical problems tests and exams related to pregnancy Transportation for an employee s vehicle involving intercontinental andor marine transportation No services shall be available for any employee if such services are required as a result of 1. Mild lesions simple fractures or mild sickness which can be treated by local doctors and do not prevent the employee from continuing his her trip or returning home 2. Pregnancies except in case of major vital complication for mother andor baby and 8. Services for which request is made after we have paid the policy limit or incurred expenses which exceed the policy limit Conditions Errors and Omissions We are not liable for any act or omission by a local doctor or attorney who is not our employee nor the employee of a third party provider of the assistance services described in this section of the policy. We can not be held responsible for failure to provide or for delay in providing services when such failure or delay is caused by conditions beyond our control including but not limited to flight conditions strike riot civil commotion war or uprising or where rendering of service is prohibited by local laws or regulations. K4F 2122016 IT1084 version date 09 2008 Page 9 of 15 | 2 |
Transfer of Rights of Recovery against Others to Us If you or the employee to whom we render assistance have any rights to recover all or any part of the cost of services rendered under this coverage part from any other people or organization including rights to recover under any workers compensation law health plan or insurance policies we are entitled to an assignment of those rights to the extent of our benefit payments. You and your employee shall transfer those rights to us and cooperate with us as may be necessary to enforce such rights. You and your employee agree to sign any papers deliver them to us and do anything else that we may reasonably require to help us pursue such rights. Suits Against Us You agree not to bring suit against us unless you have complied with all the terms of this policy. Any such suit must be brought within two years after assistance services are rendered. No person or organization has any right to bring us into any action to determine your liability. Return to Work You have the responsibility for the decision of whether or not an employee returns to work. You are responsible for obtaining any medical releases to determine employee s suitability to travel or not or to resume work or not. The decision and the results thereof are solely the responsibility of the employee you andor the employee s attending physician. We are not involved in such decisions. Services Not Covered You agree to reimburse us or our designee for services rendered on your behalf which are not covered in this policy when such services are requested or approved by a corporate officer whose name you have given us to contact or when such services are provided in good faith to any employee not covered by reason of cancellation of this policy or coverage. CONTINGENT EMPLOYERS LIABILITY COVERAGE We will pay all sums you legally must pay as damages because of bodily injury to your employees provided the bodily injury is covered by this Contingent Employers Liability Coverage The damages we will pay where recovery is permitted by law include damages 1. for which you are liable to a third party by reason of a claim or suit against you by that third party to recover the damages claimed against such third party as a result of injury to your employee 2. for care and loss of services 8. for consequential bodily injury to a spouse child parent brother or sister of the injured employee provided that these damages are the direct consequence of bodily injury that arises out of and in the course of the injured employee s employment by you and 4. because of bodily injury to your employee that arises out of and in the course of employment claimed against you in a capacity other than as employer. How This Insurance Applies This employers liability insurance applies to bodily injury by accident bodily injury by disease and bodily injury by endemic disease. Bodily injury includes resulting death. The bodily injury must arise out of and in the course of the injured employee s employment by you. The workplace of the employee must be within the coverage territory. K4F 2122016 IT1084 version date 09 2008 Page 10 of 15 | 2 |
Bodily injury by accident must occur during the Policy Period. Bodily injury by disease must be caused or aggravated by the conditions of your employment. The employee s last day of last exposure to the conditions causing or aggravating such bodily injury by disease must occur during the Policy Period. Bodily injury by endemic disease must be caused by disease which your employee may reasonably be thought to have contracted by being in a place as a result of your employment. The employee must have been in a place where the disease contracted is known to occur. The time the employee was in the place where the disease occurs must have been within the Policy Period. The employee s last day of last exposure to the conditions causing or aggravating such bodily injury by disease must occur during the Policy Period. Exclusions This insurance does not cover 1. liability assumed under a contract. This exclusion does not apply to a warranty that your work will be done in a workmanlike manner punitive or exemplary damages because of bodily injury to an employee employed in violation of law bodily injury to an employee while employed in violation of law with your actual knowledge or the actual knowledge of any of your executive officers any obligation imposed by a workers compensation occupational disease unemployment compensation or disability benefits law or any similar law bodily injury intentionally caused or aggravated by you damages arising out of the discharge of coercion of or discrimination against any employee in violation of law. bodily injury sustained by any a. master or crew member of any vessel or of the flying crew of any aircraft b. employee in the course of any employment subject to United States Government workers compensation laws including Jones Act Longshoremen and Harbor Workers Compensation Act Defense Base Act or War Hazards Compensation Act or any amendment or replacement of those Acts. Limits of Liability Our liability to pay for damages is limited. Our limits of liability are shown in the Declarations. They apply as explained below. 1. Bodily Injury by Accident. The limit shown for bodily injury by accident each accident is the most we will pay for all damages covered by this insurance because of bodily injury to one or more employees in any one accident. A disease is not bodily injury by accident unless it results directly from bodily injury by accident. Bodily Injury by Disease. The limit shown for bodily injury by disease including by endemic disease policy limit is the most we will pay for all damages covered by this insurance and arising out of bodily injury by disease including by endemic disease regardless of the number of employees who sustain bodily injury by disease. The limit shown for bodily injury by disease including by endemic disease each K4F 2122016 IT1084 version date 09 2008 Page 11 of 15 | 2 |
employee is the most we will pay for all damages because of bodily injury by disease to any one employee. Bodily injury by disease does not include disease that results directly from a bodily injury by accident. 3. We will not pay any claims for damages after we have paid the applicable limit of our liability under this insurance. EXCLUSION ALL COVERAGES War This insurance does not cover loss arising out of war whether or not declared invasions insurrection rebellion hostilities revolution or usurped power. CONDITIONS ALL COVERAGES Premium Basis Premiums for each work classification is determined by multiplying a rate times a premium basis. Remuneration is the most common premium basis. This premium basis includes payroll allowances relating to expatriate employment and all other remuneration paid or payable during the Policy Period for the services of 1. all your officers and employees engaged in work covered by this policy and 2. all other persons engaged in work that could make us liable under this policy. If you do not have payroll records for these persons the contract price for their services and materials may be used as the premium basis. You will allocate reported remuneration or other premium basis between categories for North Americans Third Country Nationals and Local Nationals or such other categories as you and we may agree. Final Premium The premium shown in the Declarations is an estimate. The final premium for each period of this policy will be determined after the end of such period by using the actual not the estimated premium basis and the classifications and rates that apply to the business and work covered by this policy. If the final premium is more than the premium you paid to us you must pay us the balance. If it is less we will refund the balance to you. If this policy is canceled the final premium will be calculated pro rata based on the time this policy was in force. Long Term Policy If the Policy Period is longer than one year and sixteen days all provisions of this coverage form will apply as though a new policy were issued on each annual anniversary that this policy is in force. Who is Insured You are insured if you are an employer shown as a Named Insured in the Declarations. If you are designated in the Declarations as a partnership and if you are one of its partners you are insured but only in your capacity as an employer of the partnership s employees. K4F 2122016 IT1084 version date 09 2008 Page 12 of 15 | 2 |
We Will Defend We have the right and duty to defend at our expense any claim proceeding or suit against you for voluntary compensation benefits for repatriation or for damages for employers liability payable by this insurance. We have the right to investigate and settle these claims proceedings or suits. We have no duty to defend a claim proceeding or suit that is not covered by this insurance. We have no duty to defend or continue defending after we have paid our applicable limit of liability under this insurance. We Will Also Pay We will also pay these costs in addition to other amounts payable under this insurance as part of any claim proceeding or suit we defend 1. reasonable expenses incurred at our request but not loss of earnings 2. premiums for bonds to release attachments and for appeal bonds in bond amounts up to the amount payable under this insurance 3. litigation costs taxed against you 4. interest on a judgment as required by law until we offer the amount due under this insurance and 5. expenses we incur. Your Duties If Injury Occurs Tell us at once if injury occurs that may be covered by this policy. Your other duties are listed here. 1. Provide for immediate medical and other services required by the workers compensation law. 2. Give us or our agent the names and addresses of the injured persons and of witnesses and other information we may need. 3. Promptly give us all notices demands and legal papers related to the injury claim proceeding or suit. 4. Cooperate with us and assist us as we may request in the investigation settlement or defense of any claim proceeding or suit. 5. Do nothing after an injury occurs that would interfere with our right to recover from others. 6. Do not voluntarily make payments assume obligations or incur expenses except at your own cost. Other Insurance For Voluntary Compensation Coverage the insurance under this policy is primary. For Employers Liability Coverage and Executive Assistance Services this policy is contingent. If there is other insurance or assistance service which is on the same contingent or primary basis as this insurance we will not pay more than our share of benefits and costs covered by this insurance and other insurance or self insurance. Subject to any limits of liability that may apply all shares will be equal until the loss is paid. If any insurance or self insurance is exhausted the shares of all remaining insurance will be equal until the loss is paid. K4F 2122016 IT1084 version date 09 2008 Page 13 of 15 | 2 |
DEFINITIONS ALL COVERAGES Contingent means insurance including contracts for assistance services issued to apply to claims suits or requests for assistance services brought outside the country in which the insurance was issued. Contingent insurance takes the place of primary insurance when the insured has no primary insurance coverage which applies. Contingent insurance will pay only the amount by which its limit exceeds the limits of any primary insurance including primary insurance issued on an excess basis which applies. When this insurance is contingent we have no duty to defend unless 1. the amount of the claim or suit exceeds the limits of the primary insurance which applies or 2. no primary insurance coverage applies. Coverage territory means the Coverage Territory for Employers Responsibility Coverages shown in the Declarations. Endemic disease means any disease which is 1. infectious and generally recognized as a public health hazard 2. restricted or peculiar to a locality or region and 3. not disease caused or aggravated by the conditions of your employment. Employee means anyone employed by the Named Insured including any voluntary worker. At your option employee may include individuals who are independent contractors with whom you have a written contract in which you agree to provide them the benefits of voluntary compensation. Expatriate Employees means that for employees of your workplaces to which this insurance applies and which are not excluded from the applicable coverage territory shown in the Declarations this insurance applies from the moment you hire or assign such an employee to a workplace outside the home country or country of residence of that employee. If you agree with an employee whose home country or country of residence is other than that of the intended workplace to grant benefits as though the employee had been hired or assigned while outside the country of intended workplace this insurance will cover such benefits. This insurance will cease to apply to such an employee when the employee s employment or assignment in such workplace ends however this insurance shall continue to apply during the prompt return of the employee to the place from which assignment or employment commenced. If you are found legally liable under the provisions of the workers compensation law of any state other than that of the workplace for which you hired or to which you assigned such employee we will adjust and settle for you all sums which you become obligated to pay by reason of such law. Primary means insurance issued to respond prior to other insurance to claims or suits brought in the country in which such insurance was issued. Primary insurance may include insurance for claims or suits arising from K4F 2122016 IT1084 version date 09 2008 Page 14 of 15 | 2 |
occurrences which take place outside the country in which such insurance was issued. State means any nation or political sub division which has a workers compensation law and includes the states of the United States of America including its territories and possessions the District of Columbia and Puerto Rico. State of hire means the state in which you hire or from which you assign an employee for work at a workplace within another country or countries shown in the coverage territory to which this insurance applies. Temporary Travel means that for employees of your workplaces located in the United States of America including its territories and possessions and Puerto Rico this insurance only applies to claims or suits arising from temporary travel on your business outside of the country of their workplace. For employees of your workplaces to which this insurance applies and which are not excluded from the applicable coverage territory shown in the Declarations this insurance also applies to claims or suits arising from temporary travel on your business in the United States of America including its territories and possessions and Puerto Rico. If you are found legally liable under the provisions of the workers compensation law of the state of an employee s workplace for a claim or suit arising from temporary travel on your business outside the country of the employee s workplace you may voluntarily submit such claim or suit to us and we will adjust and settle such claims or suits for all sums which you would become obligated to pay by reason of such law. Voluntary compensation means the medical disability and other benefits prescribed by the workers compensation law of the state you choose when you make a claim. We will not pay the amount of any benefits which are denied an employee by reason of 1. insolvency of another insurance company state fund or self insurance plan or 2. your failure to comply with the requirements of any state that you maintain workers compensation and employers liability insurance in that state. Workers compensation law means the workers or workmen s compensation law and occupational disease law of any state. It includes any amendments to that law which are in effect during the Policy Period. It does not include the provisions of any law that provide non occupational disability benefits. For a state which has no comparable law it means whatever are the customary benefits for medical care and loss of wages that would be provided to an injured worker whether provided by the employer or by the state. K4F 2122016 IT1084 version date 09 2008 Page 15 of 15 | 2 |
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aceusa ACCIDENTAL DEATH AND DISMEMBERMENT AND MEDICAL EXPENSE COVERAGE FORM SCHEDULE OF BENEFITS INSURANCE APPLIES ONLY TO THOSE COVERAGES FOR WHICH A PRINCIPAL SUM IS SHOWN. Regardless of the number of accidents occurrences covered persons or claims we shall not be liable for any amount in excess of the applicable aggregate limits of liability set out in this Schedule of Benefits and in the Description of Benefits and Sub limits Applicable to Covered Persons. If in the absence of this provision we would pay more than the amount of such aggregate limits for a particular coverage then the benefits payable to each covered person with a valid claim for such coverage will be reduced proportionately so that the total amount we will pay for such coverage is no greater than the applicable aggregate limits. This coverage form shall be considered supplemental coverage provided to coverage under a group health plan. Notwithstanding any provisions in the Policy including any endorsements or amendments thereto this coverage form shall not differentiate among individuals in eligibility benefits or premiums based on any health factor of the individual or any dependent of the individual. A. ACCIDENTAL DEATH AND DISMEMBERMENT AGGREGATE BENEFIT MAXIMUM We will not pay more than the Accidental Death and Dismemberment Principal Sum set forth in the declarations per accident per covered person for covered losses under the Accidental Death and Dismemberment section of this coverage form. B. MEDICAL EXPENSE AGGREGATE BENEFIT MAXIMUM We will not pay more than the Medical Expense Principal Sum set forth in the declarations per accident per covered person for covered losses under the Medical Expense Benefits section of this coverage form. C. AGGREGATE POLICY LIMIT OF LIABILITY FOR ACCIDENTAL DEATH AND DISMEMBERMENT AND MEDICAL EXPENSE 1500000 We will not pay more than the Aggregate Limit of Liability for all covered losses under the Medical Expense Benefits or the Accidental Death and Dismemberment sections of this coverage form regardless of the number of covered persons or accidents involved. SUMMARY OF BENEFITS AND SUBLIMITS APPLICABLE TO COVERED PERSONS SUBJECT TO THE BELOW TERMS AND CONDITIONS Schedule of Benefits Limit stated in Accidental Death and Dismemberment and Medical Expense Declarations Accidental Death and Dismemberment Aggregate Benefit Maximum Limit stated in Accidental Death and Medical Expense Aggregate Benefit Maximum Dismemberment and Medical Expense Declarations Aggregate Policy Limit of Liability for Accidental Death and Dismemberment and Medical Expense 1500000 Schedule of Benefits continues on page 2 K4F 2122016 IT7033 version date 05 2011 Page 1 of 11 | 2 |
Schedule of Benefits continued from page 1 The following sub limits apply subject to the Medical Expense Aggregate Benefit Maximum The amount of benefits specified below shall apply to each covered persons per accident subject to all terms of the coverage form having reference thereto. Maximum for Dental Treatment Injury Only 1000 Maximum for Emergency Medical Treatment of Pregnancy 2000 Maximum for Ambulance service per occurrence 250 Deductible per Covered Accident or Sickness 50 Co insurance Rate 100 of all Covered Expenses Maximum Benefit Period 1 year from the date of the Covered Accident or Sickness Daily Intensive Care Unit Benefit 800 Daily Hospital Benefit 400 Time Period of Hospital Confinement 30 days Maximum Period of Coverage for any one trip 180 continuous days HAZARDS INSURED AGAINST We will pay benefits according to the Schedule of Benefits described in this coverage form when a covered persons suffers an injury as a result of a covered accident or sickness in the coverage territory while engaged in a covered activity. We will only pay benefits if the covered persons is engaged in the hazard described below as Business Travel and Sojourn when the covered accident or sickness occurs. Unless otherwise specified we will pay benefits only once for any one covered accident or sickness. Business Travel and Sojourn We will pay the benefits described in this coverage form only if a covered persons suffers a covered loss or incurs covered expenses as the direct result of a covered accident or sickness while traveling 1. outside of his or her home country 2. up to the Maximum Period of Coverage for any one Trip shown in the Schedule of Benefits 3. on business travel for the named insured and 4. inthe course of the named insured s business or while on Sojourn DESCRIPTION OF BENEFITS The following provisions explain the benefits available under this coverage form. A. ACCIDENTAL DEATH AND DISMEMBERMENT BENEFITS If injury to the covered persons results while this coverage form is in effect and within the coverage territory for any one of the losses shown below we will pay the percentage of the Accidental Death and Dismemberment Aggregate Benefit Maximum shown below for that loss. The Accidental Death and Dismemberment Aggregate Benefit Maximum is shown in the Accidental Death and Dismemberment Declarations. If multiple losses occur only one Benefit Amount the largest will be paid for all losses due to the same accident. num K4F 2122016 IT7033 version date 05 2011 Page 2 of 11 | 2 |
Covered Loss Benefit Amount Life 100 of the Accidental Death and Dismemberment Aggregate Benefit Maximum Two or more Members 100 of the Accidental Death and Dismemberment Aggregate Benefit Maximum One Member 50 of the Accidental Death and Dismemberment Aggregate Benefit Maximum Thumb and Index Finger of the Same Hand 25 of the Accidental Death and Dismemberment Aggregate Benefit Maximum Four Fingers of the Same Hand 25 of the Accidental Death and Dismemberment Aggregate Benefit Maximum Member means Loss of Hand or Foot Loss of Sight Loss of Speech and Loss of Hearing. Loss of Hand or Foot means complete Severance through or above the wrist or ankle joint. Loss of Sight means the total permanent Loss of Sight of one eye. Loss of Speech means total and permanent loss of audible communication that is irrecoverable by natural surgical or artificial means. Loss of Hearing means total and permanent Loss of Hearing in both ears that is irrecoverable and can not be corrected by any means. Loss of a Thumb and Index Finger of the Same Hand or Loss of Four Fingers of the Same Hand means complete Severance through or above the metacarpophalangeal joints of the same hand the joints between the fingers and the hand. Severance means the complete separation and dismemberment of the part from the body. Age Reduction Schedule The amount payable for a loss will be reduced if a covered person is age 70 or older on the date of the covered accident causing the loss. The mount payable for the covered person s loss is a percentage of the amount that would otherwise be payable as shown below. PERCENTAGE OF BENEFIT AMOUNT AGE ON DATE OF COVERED ACCIDENT OTHERWISE PAYABLE 70 74 65 75 79 45 80 84 30 85 and older 20 Premium for a Covered Person age 70 or older is based on 100 of the coverage that would be in effect if the Covered Person were under age 70. Age as used above refers to the age of the covered person on his or her most recent birthday. B. MEDICAL EXPENSE BENEFITS We will pay Medical Expense Benefits for covered expenses that result directly and from no other cause from a covered accident or sickness. These benefits are subject to the Deductibles Coinsurance Rates Benefit Periods Benefit Maximums and other terms or limits shown in the Schedule of Benefits. The coinsurance rate of 100 means that we will pay for 100 of such covered expenses in excess of the deductible. Medical Expense Benefits are only payable 1. when they are in excess of amounts paid by any other Health Care Plan 2. for usual and customary charges incurred after any applicable deductible has been met 3. for those medically necessary covered expenses that the covered persons receives and 4. for charges incurred for services rendered to the covered persons while on a covered trip. 1T7033 version date 05 2011 Page 3 of 11 K4F 2122016 K4F 2122016 Page 3 of 11 | 2 |
No benefits will be paid for any expenses incurred that in our judgment are in excess of usual and customary charges. Covered Medical Expenses 1. 17. 18. Hospital semi private room and board or room and board in an intensive care unit hospital ancillary services including but not limited to use of the operating room or emergency room. Medical care services and treatment performed by a doctor as a result of bodily injury or sickness including second surgical opinions. Ambulance services to or from a hospital. Laboratory tests. Radiological procedures radium therapy x ray treatments and examination microscopic tests or any related laboratory tests or analysis made for diagnosis or treatment. Anesthetics and their administration. Blood blood products artificial blood products and the transfusion thereof. Physiotherapy. Chiropractic expenses on an inpatient or outpatient basis.. Medicines or drugs administered by a doctor or that can be obtained only with a doctor s written prescription.. Dental charges for injury to sound natural teeth.. Emergency medical treatment of pregnancy.. Artificial limbs or eyes not including replacement of these items.. Casts splints trusses crutches and braces not including replacement of these items or dental braces.. Oxygen or rental equipment for administration of oxygen.. Rental of a wheelchair or hospital type bed. Rental of mechanical equipment for treatment of respiratory paralysis. Eyeglasses contact lenses and hearing aids when damage occurs as a result of a covered accident that requires medical treatment. lll. EXCLUSIONS We will not pay benefits for any loss injury or sickness that is caused by or results from A. intentionally self inflicted injury suicide or attempted suicide. B. war or any act of war whether declared or not. C. service in the military naval or air service of any country. K4F 2122016 IT7033 version date 05 2011 Page 4 of 11 | 2 |
P. commission of or attempt to commit a felony an assault or other illegal activity. participating in motorcycling driving scuba diving skiing mountain climbing sky diving professional or amateur racing bungi cord jumping parachuting skydiving parasailing ziplining cave tubing or hang gliding. travel in or on any on road or off road motorized vehicle not requiring licensing as a motor vehicle. piloting or serving as a crewmember in any aircraft. flight in boarding or alighting from any craft or device designed to fly above the earth s surface or used in connection with any test or experimental purpose. flight in boarding or alighting from an aircraft except as 1. afare paying passenger on a regularly scheduled commercial or charter airline 2. a passenger in a non scheduled private aircraft used for pleasure purposes with no commercial intent during the flight 3. apassenger in a United States military aircraft or as a passenger on aircraft operated by the service of a duly constituted governmental authority of any other country travel in any aircraft owned leased or controlled by you or any of your subsidiaries or affiliates. An aircraft will be deemed to be controlled by you if the aircraft may be used as you wish for more than 10 consecutive days or more than 15 days in any year. the covered persons being legally intoxicated as determined according to the laws of the jurisdiction in which the injury occurred. injury or sickness that occurs while the covered persons has been determined to be legally intoxicated as determined according to the laws of the jurisdiction in which the injury or sickness occurred or under the influence of any narcotic barbiturate or hallucinatory drug unless administered by a doctor and taken in accordance with the prescribed dosage.. alcoholism drug addiction or the use of any drug or narcotic except as prescribed by a doctor. the covered persons is under the influence of drugs or intoxicants unless taken under the advice of a doctor. injury or sickness where the covered persons s trip to the coverage territory is undertaken for treatment or advice for such injury or sickness except as provided in this coverage form. Nuclear incidents of any kind or description. In addition to the exclusions above we will not pay Medical Expense Benefits for any loss treatment or services resulting from or contributed to by A. B. C. routine physicals and care of any kind. routine dental care and treatment. routine nursery care. K4F 2122016 IT7033 version date 05 2011 Page 5 of 11 | 2 |
o z g u. injury or sickness which results from or in the course of a covered persons regular occupation for pay or profit. This does not apply to corporate officer partner or sole proprietor who is not insured under Workers Compensation Employer s Liability Law or similar law. injury or sickness for which benefits are paid or payable under any Workers Compensation or Occupational Disease Law or Act or similar legislation whether United States federal or foreign law. cosmetic surgery except for reconstructive surgery needed as the result of an injury or sickness. any elective treatment examination or surgery including elective termination of pregnancy and including any service treatment or supplies that are deemed by us to be experimental and which are not recognized and general accepted medical practices in the United States. eye refractions eyeglasses contact lenses or hearing aids or examinations for the purpose of prescribing corrective lenses or hearing aids or for the fitting thereof unless caused by an injury or sickness and otherwise covered under this coverage form. medical expenses for which the covered persons would not be responsible for in the absence of this coverage form. Expenses incurred for services provided by any government hospital or agency or government sponsored plan for which and to the extent that the covered persons is eligible for reimbursement. any treatment provided under any mandatory government program or facility set up for treatment without cost to any covered persons. expenses payable by any automobile insurance policy without regard to fault. organ or tissue transplants and related services.. custodial care. mental and nervous disorders unless otherwise provided in this coverage form. pregnancy or childbirth unless otherwise provided in the coverage form. This exclusion does not apply if treatment is required as a result of a medical emergency. any care furnished to a newborn child including hospital nursery expenses. services supplies or treatment including any period of hospital confinement which is not recommended approved and certified as medically necessary and reasonable by a doctor or expenses which are non medical in nature. bacterial infection or related surgical or medical treatment thereof except for any bacterial infection resulting from an accidental external cut or wound or accidental ingestion of contaminated food. treatment or service provided by a private duty nurse. expenses incurred during the trip for purposes of seeking medical care or treatment or for any other trip that is not in the course of the insured s activity. treatment by an Immediate Family Member or member of the insured s household. This insurance does not apply to the extent that trade or economic sanctions or regulations prohibit Us from providing insurance including but not limited to the payment of claims. K4F 2122016 IT7033 version date 05 2011 Page 6 of 11 | 2 |
IV. DEFINITIONS Please note certain words used in this document have specific meanings. These terms will be shown with quote marks throughout the document. The definition of any word if not defined in the text where it is used may be found either in this Definitions section or in the Schedule of Benefits. Accident means a sudden unexpected and unintended event. Active service means a covered persons is actively at work performing all the regular duties on a full time basis either at your place of business or some place you require him or her to be. Country of Permanent Assignment means a country other than a covered persons home country in which the named insured requires a covered Person to work for a period of time that exceeds 180 continuous days. Country of Permanent Residence means a country or location in which the covered persons maintain a primary permanent residence. Coverage territory means anywhere in the world except the home country of a covered persons or as may be specifically restricted or prohibited by law. Covered accident means an accident that occurs in the coverage territory while coverage is in force for a covered persons and results in a loss or injury covered by this coverage form for which benefits are payable. Covered activity means any activity in which a covered persons must be engaged when a covered accident occurs in order to be eligible for benefits under this coverage part. These covered activities are listed in the Hazards section of the coverage part entitled Business Travel or Sojourn. Covered expenses means expenses actually incurred by or on behalf of a covered persons for treatment services and supplies covered by this coverage form. Coverage under this coverage form must remain continuously in force from the date of the covered accident or sickness until the date treatment services or supplies are received in order for them to be a covered expense. A covered expense is deemed to be incurred on the date such treatment service or supply that gave rise to the expense or the charge was rendered or obtained. Covered loss or Covered losses means an accidental death dismemberment or other injury covered under this coverage form. Covered persons means a North Americans meaning your employees who are in active service and who are citizens or legal permanent residents of the United States including its territories and possessions b Third Country Nationals meaning your employees who are in active service and who are not citizens of their country of permanent assignment and who are not described as North Americans or c Local Nationals meaning your employees who are in active service and who are citizens of the country of their workplace but who are not described as North Americans. Dependents are considered covered persons if a principal sum is set forth in the declarations. Covered persons are covered only while engaged in covered activities while within the coverage territory. K4F 2122016 IT7033 version date 05 2011 Page 7 of 11 | 2 |
Deductible means the dollar amount of covered expenses that must be incurred as an out of pocket expense by each covered persons on a per accident or sickness basis before Medical Expense Benefits paid on an expense incurred basis are payable under this coverage form. Dependent means a covered persons s lawful spouse including state law recognized domestic partners or a covered persons s unmarried child from the moment of birth to age 19 25 if a full time student who is chiefly dependent on the covered persons for support. A child includes a covered persons s natural child adopted child beginning with any waiting period pending finalization of the child s adoption or a stepchild who resides with the covered persons or depends chiefly on the covered persons for financial support. Doctor means a licensed health care provider acting within the scope of his or her license and rendering care or treatment to a covered persons that is appropriate for the conditions and locality. It will not include a covered persons a dependent immediate family member or a member of the covered persons s household. Employees means a person who works for you in the conduct of your ordinary activities in return for compensation such as salary wages commissions or stipends. Employees includes voluntary workers of the named insured. At your option employee may include individuals who are independent contractors with whom you have a written contract in which you agree to provide them the benefits of Accidental Death and Dismemberment and medical expense coverage. Health care plan means a policy or other benefit or service arrangement for medical or dental care or treatment under 1 group or blanket coverage whether on an insured or self funded basis 2 hospital or medical service organizations on a group basis 3 health maintenance organizations on a group basis 4 group labor management plans 5 employee benefit organization plans 6 association plans on a group or franchise basis or 7 any other group employee welfare benefit plan as defined in the Employee Retirement Income Security Act of 1974 as amended. Home country means a country from which the covered persons holds a passport. If the covered persons holds passports from more than one country his or her home country will be the country that he or she has declared to us or the named insured in writing. Home country also includes the covered persons country of permanent assignment or country of permanent residence. Hospital means an institution that 1 operates as a hospital pursuant to law for the care treatment and providing of in patient services for sick or injured persons 2 provides 24 hour nursing service 3 has a staff of one or more doctors available at all times 4 provides organized facilities for diagnosis treatment and surgery either i on its premises or ii in facilities available to it on a pre arranged basis 5 is not primarily a nursing care facility rest home convalescent home or similar establishment or any separate ward wing or section of a hospital used as such and 6 is not a place solely for drug addicts alcoholics or the aged. Hospital confinement means a stay of 24 or more consecutive hours as a registered resident bed patient in a hospital. Immediate family member means a person who is related to the covered persons in any of following ways spouse including state law recognized domestic partners parent includes stepparent K4F 2122016 IT7033 version date 05 2011 Page 8 of 11 | 2 |
child age 18 or older includes legally adopted and step child brother or sister includes stepbrother or stepsister parent in law son or daughter in law and brother or sister in law. Injury means accidental bodily harm sustained by a covered persons that results directly and independently from all other causes from a covered accident. The injury must be caused solely through external violent and accidental means. All injuries sustained by one person in any one accident including all related conditions and recurrent symptoms of these injuries are considered a single injury. Medical emergency means a condition caused by an injury or sickness that manifests itself by symptoms of sufficient severity that a prudent lay person possessing an average knowledge of health and medicine would reasonably expect that failure to receive immediate medical attention would place the health of the person in serious jeopardy. Medically necessary means a treatment service or supply that is 1 required to treat an injury or sickness prescribed or ordered by a doctor or furnished by a hospital 2 performed in the least costly setting required by the covered persons s condition and 3 consistent with the medical and surgical practices prevailing in the area for treatment of the condition at the time rendered. Purchasing or renting 1 air conditioners 2 air purifiers 3 motorized transportation equipment 4 escalators or elevators in private homes 5 eye glass frames or lenses 6 hearing aids 7 swimming pools or supplies for them and 8 general exercise equipment are not medically necessary. A service or supply may not be medically necessary if a less intensive or more appropriate diagnostic or treatment alternative could have been used. We may at our discretion consider the cost of the alternative to be the covered expense. Sickness means an illness disease or condition of the covered persons that causes a loss for which a covered persons incurs medical expenses while covered under this coverage form. All related conditions and recurrent symptoms of the same or similar condition will be considered one sickness. Sojourn means personal trips taken by the covered persons on vacation days personal days holidays weekend days or business days a while on the business of the named insured and b not exceeding a total of fourteen days Trip means travel by air land or sea and is deemed to commence when the covered persons leaves his or her home country on a trip within the coverage territory and shall continue until such time the covered persons returns to his or her home country. It includes the period of time from the start of the trip until its end provided the covered persons is engaged in a covered activity. Usual and customary charge means the average amount charged by most providers for treatment service or supplies in the geographic area where the treatment service or supply is provided. We our us means the insurance company underwriting this insurance. You or your means the Named Insured listed on the Declarations. K4F 2122016 IT7033 version date 05 2011 Page 9 of 11 | 2 |
V. CLAIM PROVISIONS A. Notice Of Claim A claimant must give us or our authorized representative written or authorized electronic or telephonic notice of claim within 90 days after any loss covered by this coverage form occurs. If notice can not be given within that time it must be given as soon as reasonably possible. This notice should identify the covered persons and this coverage form. Claim Forms Upon receiving written notice of claim we will send claim forms to the claimant within 15 days. If we do not furnish such claim forms the claimant will satisfy the requirements of written proof of loss by sending the written or authorized electronic or telephonic proof as shown below. The proof must describe the occurrence extent and nature of the loss. Proof Of Loss Written or authorized electronic or telephonic proof of loss must be sent to the authorized representative authorized to receive it. Written or authorized electronic or telephonic proof must be given within 90 days after the date of loss. If it can not be provided within that time it should be sent as soon as reasonably possible. In no event except in the absence of legal capacity will proof of loss be accepted if it is sent later than one year from the time proof is otherwise required. Claimant Cooperation Provision Failure of a claimant to cooperate with us in the administration of a claim may result in the termination of a claim. Such cooperation includes but is not limited to providing any information or documents needed to determine whether benefits are payable or the actual benefit amount due. Clerical Error If a clerical error is made it will not affect the insurance of any covered persons. No error will continue the insurance of covered persons beyond the date it should end under the Policy terms. Time Payment Of Claims Any benefits due will be paid when we receive written or authorized electronic or telephonic proof of loss. Payment Of Claims If the covered persons dies any death benefits or other benefits unpaid at the time of the covered persons s death will be paid to their beneficiary. If no beneficiary is on record with us or our authorized representative we will pay benefits in equal shares to the first surviving class of the following to the covered persons s 1. spouse 2. children in equal shares If a child is a minor benefits will be paid to the legal guardian 3. parents in equal shares 4. brothers and sisters in equal shares If there are no survivors in any of these classes we will pay the covered person s estate. All other benefits due and not assigned will be paid to the covered persons if living. Otherwise the benefits may at our option be paid 1. according to the beneficiary designation or 2. to the covered persons s estate. If a benefit due is payable to 1. the covered persons s estate or K4F 2122016 IT7033 version date 05 2011 Page 10 of 11 | 2 |
2. the covered persons or a beneficiary who is either a minor or is not competent to give a valid release for the payment We may pay any amount due to some other person. The other person will be one who we believe is entitled to the payment and who is related to the covered persons or the beneficiary by blood or marriage. We will be relieved of further responsibility to the extent of any payment made in good faith. We may pay benefits directly to any hospital doctor or person or organizations rendering covered services unless the covered persons requests otherwise in writing. The covered persons must make the request no later than the time he or she files a written proof of loss. Beneficiary The covered persons may designate a beneficiary. The covered persons has the right to change the beneficiary at any time by written or electronic and telephonic notice. The change will be effective when we or our authorized representative receive it. When received the effective date is the date the notice was signed. We are not liable for any payments made before the change was received. We can not attest to the validity of a change. Assignment We may pay benefits directly to any hospital doctor or person or organization rendering covered services unless the covered person requests otherwise in writing no later than the time he or she submits written proof of loss. Any payment made in good faith will end our liability to the extent of the payment. Physical Examinations And Autopsy We have the right to have a doctor of our choice examine the covered persons as often as is reasonably necessary. This section applies when a claim is pending or while benefits are being paid. We also have the right to request an autopsy in the case of death unless the law forbids it. We will pay the cost of the examination or autopsy. Recovery of Overpayment If benefits are overpaid or paid in error we have the right to recover the amount overpaid or paid in error by any or all of the following methods. 1. Arequest for lump sum payment of the amount overpaid or paid in error. 2. Reduction of any proceeds payable under this coverage form by the amount overpaid or paid in error. 3. Taking any other action available to us. Legal Actions No lawsuit or action in equity can be brought to recover on the benefits provided by this coverage form 1 before 60 days following the date proof of loss was given to us or 2 after 3 years following the date proof of loss is required.. Not In Lieu Of Workers Compensation This coverage form is not a Workers Compensation policy. It does not provide Workers Compensation benefits. K4F 2122016 IT7033 version date 05 2011 Page 11 of 11 | 2 |
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CORPORATE KIDNAP AND EXTORTION COVERAGE FORM aceusa In consideration of the payment of the premium and in reliance upon the Application and all representations materials and information made or submitted by you or your representatives in connection therewith we agree to indemnify you for Covered Losses sustained directly as a result of Covered Events which occur during the Policy Period and subject to the Declarations terms conditions limitations and exclusions of this Coverage Form as modified by the other terms conditions limitations and exclusions of this Policy. You agree to pay the premium supply designated information and comply with the provisions of this Coverage Form as modified by the other terms conditions limitations and exclusions of this Policy. I. COVERED EVENT Subject to the provisions of Section Il COVERED LOSS Section V LIMITS OF LIABILITY and any Deductible shown in the Declarations coverage is afforded under this Coverage Form for one or more of the Covered Losses identified in the Declarations arising solely and directly from the following specific Covered Events that commence during the Policy Period A. Kidnap B. Extortion C. Wrongful Detention Il. COVERED LOSS If a Covered Event commences during the Policy Period we will indemnify you for the following subject to Section VI CONDITIONS PRECEDENT TO OUR LIABILITY and any other applicable terms and conditions of this Policy A. EXTORTION RANSOM MONIES PAYMENT We will reimburse you for Extortion Ransom Monies paid by you or a Covered Persons resulting directly from the following Covered Events commencing during the Policy Period 1. Kidnap or purported Kidnap and 2. Extortion upon you or a Covered Persons. B. IN TRANSIT EXTORTION RANSOM MONIES We will reimburse you for the loss of Extortion Ransom Monies resulting directly from confiscation destruction disappearance wrongful appropriation seizure or usurpation while such Extortion Ransom Monies are being conveyed as a result of a Kidnap or Extortion by anyone who is authorized by you or a Covered Persons to have custody thereof provided that the Kidnap or Extortion that gave rise to the conveyance is a Covered Event under this Coverage Form. C. EXPENSES We will reimburse you for the amount paid by you for Expenses resulting directly from a Covered Event commencing during the Policy Period. CORPORATE KIDNAP AND EXTORTION COVERAGE FORM IT7037 version date 07 2012 Page 1 of 13 2012 K4F 2122016 | 2 |
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