AARP_Foundation_-_WOS.pdf

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Attached to
Master Agreement AZ|CTR065009
Contract number
CTR065009
Issued by
Arizona

About this file

This document is a Workers Compensation and Employers Liability Insurance Policy Endorsement issued by ARCH INSURANCE COMPANY for AARP Premium INCL., with an effective date of 07/01/2023. The endorsement specifically involves a Waiver of Right to Recover from Others, with the primary beneficiary being the STATE OF ARIZONA, including its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees for losses arising from work performed by or on behalf of the contractor.

The endorsement modifies the insurance policy to prevent the insurance company from enforcing recovery rights against the specified Arizona state entities for workplace injuries. There are specific provisions for Missouri-based policies, which allow for waiver of subrogation through written contracts executed prior to a loss, with exceptions for certain construction classification groups. The document is a standard insurance form (WC 00 03 13) published by the National Council on Compensation Insurance, designed to provide legal protection and clarify subrogation rights in workers' compensation scenarios.

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Text version

This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated.

(The information below is required only when this endorsement is issued subsequent to preparation of the policy.)

Endorsement Effective 07/01/2023 Policy No. 11WCI4937116 Endorsement No.001

Insured AARP Premium INCL.

Insurance Company ARCH INSURANCE COMPANY

Countersigned By

WC 00 03 13

(Ed. 4-84)

1983 National Council on Compensation Insurance.

WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13

(Ed. 4-84)

WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT

We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.)

This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule.

Schedule

STATE OF ARIZONA, AND ITS DEPARTMENTS,

AGENCIES, BOARDS, COMMISSIONS,

UNIVERSITIES, OFFICERS, OFFICIALS, AGENTS

AND EMPLOYEES FOR LOSSES ARISING

FROM WORK PERFORMED BY OR ON

BEHALF OF THE CONTRACTOR

For policies or exposure in Missouri:

Any person or organization for which the employer has agreed by written contract, executed prior to loss, may execute a waiver of subrogation. However, for purposes of work performed by the employer in Missouri, this waiver of subrogation does not apply to any construction group of classifications as designated by the waiver of right to recover from others (subrogation) rule in our manual.

File details come from the government source that posted it. Updated .