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TeofficersoremployeeslastdayofIftepersonsentitledtoteenefitsoftis <br />lasteposretoteconditionscasinginsrancemaearecoeryfromoters,tey <br />oraggraatingscodilyinryymst reimrse s for te enefits we paid tem. <br />diseasemstoccrdringtepolicy <br />G/Fnqmpzfst“!Mjbcjmjuz!Jotvsbodf <br />period. <br />PartTwoEmployersLiailityInsranceapplies <br />C/Xf!Xjmm!Qbz <br />toodilyinrycoeredytisendorsementas <br />WewillpayanamontealtoteenefitstogteStateofEmploymentwassownin <br />tatwoldereiredofyoasifyoandItem 3.A. of te Information Page. <br />yoremployeesweresecttoteworers <br />Tisproision.doesnotapplyinewerseyor <br />compensationlawofanystatesowninItem <br />Wisconsin. <br />3.A.ofteInformationPage.Wewillpay <br />FNQMPZFST“!MJBCJMJUZ!TUPQ!HBQ!DPWFSBHF <br />toseamontstotepersonswowolde <br />7/Fnqmpzfst“!Mjbcjmjuz!Tupq!Hbq!Dpwfsbhf <br />entitled to tem nder te law. <br />A.TiscoerageonlyappliesinMontana,ort <br />D/Fydmvtjpo <br />Daota,Oio,Wasington,Westirginiaand <br />Tis insrance does not coer <br />Wyoming. <br />1.anyoligationimposedyworers <br />B.PartOneWorersCompensationInsrance <br />compensationoroccpationaldisease <br />doesnotapplytoworinstatessownin <br />law or any similar law. <br />Paragrap A aoe. <br />2.odilyinryintentionallycasedor <br />C.PartTwoEmployersLiailityInsranceapplies <br />aggraated y yo. <br />intestates,sowninParagrapA.,astog <br />3.officersoremployeeswoaeelected <br />teyweresowninItem3.A.ofteInformation <br />nottoesecttotestateworers <br />Page. <br />compensation law. <br />D.PartTwo,SectionC.Fydmvtjpot iscangedy <br />4.partnersorsoleproprietorsnotcoered <br />adding tese eclsions. <br />nderteStandardSoleProprietors, <br />Tis insrance does not coer <br />Partners,OfficersandOtersCoerage <br />.odilyinryintentionallycasedor <br />Endorsement. <br />aggraatedyyoorinOioodilyinry <br />E/Cfgpsf!Xf!Qbz <br />resltingfromanactwicisdeterminedy <br />Beforewepayenefitstotepersons <br />anOiocortoflawtoaeeencommitted <br />entitled to tem, tey mst <br />yyowitteelieftananinryis <br />1.Releaseyoands,inwriting,ofallsstantiallycertaintooccr.oweer,te <br />responsiility for te inry or deat.costofdefendingscclaimsorsitsinOio <br />is coered. <br />2.Transfertosteirrigttorecoerfrom <br />oterswomayeresponsileforte13.odilyinrysstainedyanymemerofte <br />inry or deat.flying crew of any aircraft. <br />3.Cooperatewitsanddoeeryting14.anyclaimforodilyinrywitrespectto <br />necessarytoenalestoenforcetewicyoaredepriedofanydefenseor <br />rigt to recoer from oters.defensesorareoterwisesecttopenalty <br />ecaseofdefaltinpremimnderte <br />Iftepersonsentitledtoteenefitsoftis <br />proisionsofteworerscompensationlaw <br />insrancefailtodotosetings,ordtyto <br />or laws of a state sown in Paragrap A. <br />payendsatonce.Ifteyclaimdamages <br />fromyoorfromsforteinryordeat,E.Tisinsranceappliestodamagesforwicyo <br />or dty to pay ends at once.arelialenderWestirginiaCodeAnnot.S23- <br />4-2. <br />F/Sfdpwfsz!Gspn!Puifst <br />Ifwemaearecoeryfromoters,wewill <br />eepanamontealtoorepensesof <br />recoeryandteenefitswepaid.Wewill <br />pay te alance to te persons entitled to it. <br />Gpsn!XD!::!14!13!C Printed in .S.A. Ed. 8/00Qbhf!4!pg!5 <br /> <br />