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PART FIVE -PREMIUM <br /> A. Our Manuals is amended by adding this sentence: <br /> In this part, "our manuals" means manuals approved or prescribed by the Texas Department of Insurance. <br /> C. Remuneration <br /> Number 2 is amended to read: <br /> 2. All other persons engaged in work that would make us liable under Part One (Workers Compensation Insurance) <br /> of this policy. This paragraph 2 will not apply if you give us proof that the employers of these persons lawfully <br /> secured workers compensation insurance. <br /> D. Premium Payments is amended by adding this sentence: <br /> The billing statement or invoice for audit additional premiums and/or retrospective additional premiums establishes the <br /> date the premium is due. <br /> E. Final Premium <br /> Number 2 is amended to read: <br /> 2. If you cancel, final premium will be calculated pro rata based on the time this policy was in force. Final premium <br /> will not be less than the pro rata share of the minimum premium. <br /> PART SIX -CONDITIONS <br /> A. Inspection is amended by adding this sentence: <br /> Your failure to comply with the safety recommendations made as a result of an inspection may cause the policy to be <br /> canceled by us. <br /> C. Transfer of Your Rights and Duties is amended to read: <br /> Your rights and duties under this policy may not be transferred without our written consent. If you die, coverage will <br /> be provided for your surviving spouse or your legal representative. This applies only with respect to their acting in the <br /> capacity as an employer and only for the workplaces listed in Items 1 and 4 on the Information Page. <br /> D. Cancellation is amended to read: <br /> 1. You may cancel this policy. You must mail or deliver advance notice to us stating when the cancellation is to take <br /> effect. <br /> 2. We may cancel this policy. We may also decline to renew it. We must give you written notice of cancellation or <br /> nonrenewal. That notice will be sent certified mail or delivered to you in person. A copy of the written notice will <br /> be sent to the Texas Department of Insurance-Division of Workers' Compensation. <br /> 3. Notice of cancellation or nonrenewal must be sent to you not later than the 30th day before the date on which the <br /> cancellation or nonrenewal becomes effective, except that we may send the notice not later than the 10th day <br /> before the date on which the cancellation or nonrenewal becomes effective if we cancel or do not renew because <br /> of: <br /> a. Fraud in obtaining coverage; <br /> b. Misrepresentation of the amount of payroll for purposes of premium calculation; <br /> c. Failure to pay a premium when payment was due; <br /> d. An increase in the hazard for which you seek coverage that results from an action or omission and that would <br /> produce an increase in the rate, including an increase because of failure to comply with reasonable <br /> recommendations for loss control or to comply within a reasonable period with recommendations designed to <br /> reduce a hazard that is under your control; <br /> e. A determination by the Commissioner of Insurance that the continuation of the policy would place us in <br /> violation of the law, or would be hazardous to the interests of subscribers, creditors, or the general public. <br /> 4. If another insurance company notifies the Texas Department of Insurance-Division of Workers' Compensation that <br /> it is insuring you as an employer, such notice must be a cancellation of this policy effective when the other policy <br /> starts. <br /> Add the following to the policy: <br /> PART SEVEN -OUR DUTY TO YOU FOR CLAIM NOTIFICATION <br /> A. Claims Notification <br /> We are required to notify you of any claim that is filed against your policy. Thereafter we must notify you of any <br /> proposal to settle a claim or, on receipt of a written request from you, of any administrative or judicial proceeding <br /> relating to the resolution of a claim, including a benefit review conference conducted by the Texas Department of <br /> Insurance-Division of Workers' Compensation. You may, in writing, elect to waive this notification requirement. <br /> We must, on the written request from you, provide you with a list of claims charged against your policy, payments <br /> made and reserves established on each claim, and a statement explaining the effect of claims on your premium rates. <br /> We must furnish the requested information to you in writing no later than the 30th day after the date we receive your <br /> request. The information is considered to be provided on the date the information is received by the United States <br /> Postal Service or is personally delivered. <br /> Form WC 42 03 01 L Printed in U.S.A, Page 2 of 3 <br />