Workers Compensation
What is the no fault system?
The system where benefits are paid regardless of fault.
What is property damage liability?
This CGL coverage protects the insured when their negligence causes physical damage to someone else’s property
What is the “care, custody, or control” exclusion?
removes coverage for damage to property in the insured’s physical possession, such as items being worked on or stored.
What is Employer’s Liability (EL)?
This coverage responds when an employee sues their employer in a non-employer role.
Why isn’t Tim’s broken leg covered under the CGL?
Not covered. A CGL policy does not cover bodily injury to the named insured (Tim), because CGL only covers liability to third parties. To be eligible, the person must be a third party—not the insured business owner.
What is contributory negligence?
A defense where the worker is blamed for their own injury.
What is personal injury coverage?
Liability for offenses such as libel, slander, or invasion of privacy
What is mobile equipment?
describes equipment designed primarily for off-road use and not considered an “auto” under the CGL.
What is dual capacity?
The doctrine allowing an employee to sue their employer as if they were a customer.
Why is a tenant’s slip-and-fall accident in the hallway covered?
Covered. The tenant is a third party injured on the premises due to a possible hazard. This falls under Coverage A: Bodily Injury and Property Damage Liability, and no exclusion applies. Tenants are not considered employees, insureds, or internal personnel.
What benefits are provided under WC statutes?
Benefits that include lost wages, medical bills, rehab, and survivor payments.
What is advertising injury coverage?
protection against liability for copyright, infringement, stolen ideas, or misappropriation.
What is the product recall (sistership) exclusion?
This exclusion eliminates coverage when the insured must fix the cost of withdrawing, recalling, or replacing a defective product.
What is residential market?
An insurance market designed for people or business who cannot obtain coverage in the voluntary market
Why is an employee injured while operating mobile equipment not covered under the CGL?
Not covered by the CGL. Employee bodily injury is excluded under the Employer’s Liability Exclusion (Coverage A). These injuries must be handled through Workers Compensation, not the CGL.
What are accident, arising out of employment, and in the course of employment?
The three things an injured worker must prove to receive WC benefits
What is the “Damage to your property” exclusion?
the exclusion that eliminates coverage for damage to the insured’s defective product.
What is the property you own, rent, and occupy exclusion?
This exclusion prevents coverage for property damage to premises the insured owns or regularly controls, except when rented.
What is occurrence basis policy?
A policy trigger where the loss must occur during the policy period, regardless of when the claim is reported.
Why is a false-arrest claim covered even though it was filed 10 months after the policy expired?
Covered. The CGL is written on an occurrence basis, meaning coverage applies if the wrongful act occurred during the policy period—even if the claim is made later.
False arrest and detention qualify as Personal & Advertising Injury, which is covered unless specifically excluded.
What is the third-party claim option?
When a worker sues a manufacturer and still collects WC through subrogation
What is a claims-made policy?
A policy in which the injury must be reported during the policy period and occur after the retroactive date.
What is Damage to Premises Rented to you?
This key CGL definition allows coverage for rented building damage caused by fire—but only up to a special sublimit.
What is monopolistic states?
States where workers compensation insurance can only be purchased through a state-operated fund.
What is partially covered the door is covered but “your product” is excluded?
A refrigerator delivery damages the customers door and refrigerator.