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PARTS ONE and TWO <br />PART THREE <br />I. WE WILL ALSO PAY 2. <br />Haw This Insurance Applies <br />D. We Will Also Pay of Part One (WORKERS' <br />Paragraph 4, of A. How This Insurance Applies <br />COMPENSATION INSURANCE); and <br />of part 3 (Other States Insurance) is replaced by <br />C. We Will Also Pay of Part Two (EMPLOYERS' <br />the following: <br />LIABILITY INSURANCE) is replaced by the <br />4. If you have work on the effective date of this <br />following: <br />policy In any state not listed in (team 8.A of the <br />We Will Also Pay <br />Information Page, coverage will not be <br />We will also pay these casts, In addition to <br />afforded for that state unless we are notified <br />other amounts payable under this Insurance, <br />within sixty days, <br />as part Of any claim, proceeding, or suit we <br />defend: <br />PART SIX <br />1, reasonable expenses Incurred at our 3. <br />Transfer Of Your Rights and Duties <br />request, INCLUDING loss of earnings; <br />C. Transfer Of Your Rights and Duties of Part 6 <br />2. premiums for bonds to release <br />(Conditions) is replaced by the following; <br />attachments and for appeal bonds in bond <br />Your rights or duties under this policy may riot <br />amounts up to the limit of our liability <br />be transferred without our written consent, <br />under this Insursnca; <br />If you dim and we receive notice within sixty <br />3, litigation costs taxed against you; <br />days after your death, we will cover your legal <br />4. interest an a judgment as required by law <br />representative as insured. <br />until we offer the amount due under this 4, <br />Liberalization <br />law; and <br />If we adopt a change in this form that would <br />5, expenses we Incur. <br />broaden the coverage of this form without extra <br />charge, the broader coverage wif apply to this <br />POW . It will apply when the change becomes <br />effective in your state. <br />13ECTION 11 <br />VOLUNTARY COMPENSATION AND EMPLOYERS' <br />3, The bodily injury must occur In the United <br />LIABILITY COVERAGE <br />States of America, its territories or <br />6, VOluntary Compensation insurance <br />possessions, or Canada, and may occur <br />A. How This Insurance Applies <br />elsewhere if the employee is a United <br />This Insurance applies to bodily injury by <br />States or Canadian citizen, or otherwise <br />legal resident, and legally employed, in the <br />accident or bodily injury by disease. Bodily <br />United States or Canada and temporarily <br />injury includes resulting deeth, <br />'way from those places. <br />1, The bodily injury must be sustained by any <br />A Bodily injury by accident must occur <br />officer of employee not subject to the <br />during the policy period. <br />workers' compensation law of any state <br />shown, in Item 3.A, of the Information <br />5. Bodily injury by disease must be oaused <br />Page, <br />ar aggravated by the conditions of the <br />2. The bodily injury rrmst arise out e( and in <br />the course of employment or Incidental to <br />work in a state shown in acre 3.A. of the <br />Information Page, <br />Porte VVC 99 93 03 R Printed In U.5.A. (Ed. 0100) Page 2 of 8 <br />