R-70, R-71, R-73, R-74

Transcription

1 July 21, 2000 Contact: Mr. Rchard Kaefer Chef Audtor Ext. 157 R.C To the Members of the Board RE: New York Workers Compensaton Admralty and Federal Employers Lablty Act Standard Lmt of Lablty and Table for Increased Lmts The Rates Commttee has adopted, and the New York State Insurance Department has approved, effectve October 1, 2000, for new and renewal busness, amendments to the standard lmt of lablty and Table for Increased Lmts for employers lablty coverage of employers subject to Admralty Law and the Federal Employers Lablty Act. Currently, n New York, the standard lmts of lablty for Coverage B Employers Lablty for Admralty and FELA classfcatons are $25,000 for Bodly Injury by Accdent and $25,000 for Bodly Injury by Dsease. These lmts have been n effect snce January 1, 1978 and can be ncreased based upon the lmts shown n the Appendx of the New York Workers Compensaton and Employers Lablty Insurance Manual. In New York, there s no lmt of lablty for employers lablty coverage for employees subject to the New York Workers Compensaton Law. In several other jursdctons, the standard lmt of lablty under Part Two Employers Lablty Insurance for employers subject to Admralty Law or Federal Employers Lablty Act has been ncreased to lmts of $100,000 for each accdent for Bodly Injury by Accdent and $100,000 for each employee for Bodly Injury by Dsease wth a $500,000 polcy lmt for Bodly Injury by Dsease. These lmts were based upon the standard lmts currently n effect, on a countrywde bass, for employers lablty coverage other than coverage for the Admralty and FELA classfcatons. To be consstent wth the lmts mplemented n other jursdctons, the New York Workers Compensaton and Employers Lablty Insurance Manual has been amended to nclude the same lmts of lablty for Coverage B Employers Lablty for employers subject to Admralty Law and the Federal Employers Lablty Act. Attached are revsed Pages R-70, R-71, R-73, R-74 and AC-3, as they pertan to these coverages. CD:tg Encl. Prnted manual pages wll be dstrbuted as soon as they become avalable. Very truly yours, Monte Almer Presdent

2 Page R-70 NEW YORK WORKERS COMPENSATION RULE XIII Effectve October 1, st Reprnt RULE XIII THE ADMIRALTY LAW AND THE FEDERAL EMPLOYERS' LIABILITY ACT A. ADMIRALTY LAW 1. General Explanaton Masters and members of the crews of vessels are not covered under state workers compensaton laws nor under the USL&HW Act. They are subject to admralty law and, f njured, have the rght to sue ther employers for damages n the Admralty Courts where the proceedng s n the nature of an employers' lablty sut. They also have the rght to transportaton, wages, mantenance and cure. Such seamen are subject to a Federal law, the Merchant Marne Act of 1920, known as the Jones Act (46 U.S. Code, Secton 688, 1970), whch apples the provsons of the Federal Employers' Lablty Act to seamen. Every person employed on board a vessel s deemed to be a seaman f connected wth the operaton or welfare of the vessel whle n navgable waters. Usually, navgable waters are defned as those whch form a contnuous hghway for nterstate or nternatonal commerce. 2. Descrpton of Coverage Programs The Standard Polcy may be used to provde nsurance for lablty under one or more state workers compensaton laws and also for lablty under admralty law. There are two programs to furnsh such nsurance: a. Program I Provdes coverage for statutory lablty under the workers compensaton law of any state desgnated n Item 3 of the Informaton Page, and employers lablty for damages under admralty law subject to a standard lmt of $100,000. b. Program II Provdes the same coverage as Program I, but wth the addton of voluntary compensaton. Under Program II, the nsurance carrer wll offer a settlement of a clam strctly n accord wth the statutory benefts provded n the workers compensaton law desgnated n the Voluntary Compensaton and Employers Lablty Coverage Endorsement (WC A) attached to the polcy as f the clam were subject to such law nstead of subject to the laws of neglgence. If the offer of settlement s rejected, employers lablty then apples to such clam or sut, wth the same standard lmt as for Program I. 3. Coverage Endorsements a. Admralty Law To provde Program I for admralty law, attach the Martme Coverage Endorsement (WC A). To provde Program II for admralty law, also attach the Voluntary Compensaton Martme Coverage Endorsement (WC ). b Admralty Law Coverage Opton The Martme Coverage Endorsement excludes lablty to provde transportaton, wages, mantenance and cure. Ths endorsement may optonally nclude a provson to nsure such lablty for an addtonal premum based on an (a) rate.

3 NEW YORK WORKERS COMPENSATION Page R-71 1 st Reprnt Effectve October 1, 2000 RULE XIII c. USL&HW Act When nsurance s provded for lablty under admralty law, nsurance for lablty under the USL&HW Act also may be necessary. To provde such nsurance, attach the Longshore and Harbor Workers' Compensaton Act Coverage Endorsement (WC A). 4. Lmts of Lablty a. Standard Lmt The standard lmt of lablty under Part Two Employers Lablty Insurance for admralty Program I or II s $100,000. (1) Accdent Lmt The lmt of lablty apples to all bodly njury arsng out of any one accdent. (2) Dsease Lmt The lmt of lablty also apples as a separate aggregate lmt for all bodly njury by dsease. The aggregate lmt apples separately to bodly njury by dsease arsng out of work n each state shown n Item 3.A. of the Informaton Page. (3) Show Lmts on Endorsement These lmts of lablty must be stated n the Martme Coverage Endorsement (WC A). b. Increased Lmts Increased lmts of lablty under Part Two Employers Lablty Insurance are avalable. The total premum, ncludng ncreased lmts, shall be determned by applyng the factor n the followng Table For Increased Lmts to the total premum for admralty classfcatons under Programs I or II before applcaton of: (1) Expense constant (2) Experence ratng or mert ratng modfcaton (3) Premum dscount or retrospectve ratng adjustment. The premum for ncreased lmts s subject to an experence or mert ratng modfcaton. TABLE FOR INCREASED LIMITS Factor Mnmum Premum For Increased Lmts Lmt Per Accdent Program I Program II Program I Program II $ 100, $115 $ , , , , Refer to Appendx C, Page AC-3 for lmts hgher than $500,000.

4 NEW YORK WORKERS COMPENSATION Page R-73 1 st Reprnt Effectve October 1, 2000 RULE XIII 6. Waters Not Under Admralty Jursdcton a. Coverage An nsured may conduct operatons on waters not subject to admralty jursdcton. Insurance for such operatons shall be provded by the Standard Polcy and endorsement forms and s subject to the rules whch apply to statutory workers compensaton nsurance. Rates are on the rate pages. b. Premum Determnaton The admralty classfcatons and rates for Program II apply to operatons descrbed n 1. above. Rates are on the rate pages. c. Admralty Law or USL&HW Act Lablty If there s a potental lablty under admralty law, follow the prevous rules for nsurance under admralty law. If there s a potental lablty under the USL&HW Act, refer to Rule XII. B. FEDERAL EMPLOYERS' LIABILITY ACT 1. General Explanaton The Federal Employers' Lablty Act apples to employees of nterstate ralroads. Such employees are not subject to state workers compensaton laws. Ths federal law mposes lablty for damages on the ralroad f the njured ralroad employee can show any neglgence on the part of the ralroad. For complete detals, see 45 U.S. Code, Sectons 51-60, Descrpton of Coverage In the case of a polcy coverng a ralroad engaged n nterstate commerce and subject to the Federal Employers' Lablty Act, the premum rates nclude complete coverage for statutory workers compensaton benefts or voluntary compensaton coverage for any operaton subject to that Act. As respects the lablty for the company under Part Two Employers Lablty, the rates provde for a standard lmt of $100,000 for all damages because of bodly njury or death by accdent of one or more employees n any one accdent. No such polcy shall be wrtten wth lmts less than the standard lmts provded above. 3. Coverage Endorsements a. FELA Endorsements For employments subject to FELA, the Federal Employers' Lablty Act Coverage Endorsement (WC ) shall be attached. b. Voluntary Coverage If voluntary compensaton coverage s to be afforded, the Voluntary Compensaton and Employers Lablty Coverage Endorsement (WC A) shall be attached to the polcy.

5 Page R-74 NEW YORK WORKERS COMPENSATION RULE XIII Effectve October 1, st Reprnt 4. Lmts of Lablty a. Standard Lmt The standard lmt of lablty under Part Two Employers Lablty for FELA coverage s $100,000. b. Increased Lmts Increased lmts of lablty under Part Two Employers Lablty are avalable. The total premum, ncludng ncreased lmts, shall be determned by applyng the factor n the followng Table For Increased Lmts to the total premum for FELA classfcatons, before applcaton of: (1) Expense constant (2) Experence or mert ratng modfcaton (3) Premum dscount on retrospectve ratng adjustment. The premum for ncreased lmts s subject to an experence or mert ratng modfcaton. TABLE FOR INCREASED LIMITS Factor Mnmum Premum For Increased Lmts Lmt Per Accdent Program I Program II Program I Program II $100, $115 $ , , , , Refer to Appendx C, Page AC-3 for lmts hgher than $500, Classfcatons and Rates The classfcatons, rates and mnmum premum for ralroad operatons appear under the Ralroad secton n Part II Classfcatons and Part III Rates of ths manual.

6 NEW YORK WORKERS COMPENSATION AC-3 1 st Reprnt Effectve October 1, 2000 APPENDIX C LIMIT PER ACCIDENT EMPLOYERS LIABILITY INSURANCE FOR ADMIRALTY OR FELA TABLE FOR INCREASED LIMITS FACTOR MINIMUM PREMIUM FOR INCREASED LIMITS Program I Program II Program I Program II $100, , , , , , $ $ , , , , ,000 1,000, ,500,000 2,000,000 2,500,000 3,000,000 3,500,000 4,000, ,500,000 5,000,000 6,000,000 7,000,000 8,000, ,000,000 10,000,000 15,000,000 20,000,000 25,000,