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Coverage
Forms
Policy Info
Misc
100
Susie sees her husband killed by a falling concrete block while he is working. She suffers a heart attack because of this.
What is Consequential Bodily Injury
100
Exclude Corporate officers – New York
What is WC 31 03 05 (B)
100
Coincidence Inc - Entity type?
What is Corporation
100
Gives employers a choice between purchasing Workers Compensation insurance from a state fund or from a private insurance company.
What is Competitive State Funds
200
Can work but not at full capacity
What is Temporary Partial
200
Waiver of Right to Recover from Others
What is WC 00 03 13 (00)
200
Lists all states on the policy
What is Item 3C
200
Large employers who are financially able, may use this form assuming their own costs of WC Liability.
What is Self Insurance
300
Cover’s the employer
What is Employer’s Liability
300
Endorsement that will cover volunteers
What is WC 00 03 11 A
300
Covers the employee
What is Workers Compensation – Part I
300
Rewards insureds with good loss experience and punishes insureds with bad loss experience by applying a credit or debit to the premium.
What is Experience rating
400
Surveyor loses an eye; impacts his ability to read equipment
What is Permanent Partial
400
Partners, Officers and others Exclusion Endorsement
What is WC 00 03 08
400
Garrison Paul DBA Crawlers – type of entity is…
What is Individual
400
Used when experience mod does not apply
What is Merit Rating
500
Hit in the head by a concrete block resulting in brain injury
What is Permanent Total
500
Sole Proprietors, Partners Officer Endorsement
What is WC 00 03 10
500
Somer Smith & Geoff Thomas – type of entity is…
What is Partnership
500
WA, WY, ND, OH
What is Monopolistic States