CTR051357_24-25_WC_WOS.pdf
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- Attached to
- Master Agreement AZ|CTR051357
- Contract number
- CTR051357
- Issued by
- Arizona
About this file
This document is a Workers' Compensation and Employers' Liability Policy Endorsement issued by ACE American Insurance Company for MEDIMPACT HOLDINGS INC., located in San Diego, California. The policy is effective from 04-30-2024 to 04-30-2025, with a policy number RWC Number: (25)7184-00-64. The endorsement specifically addresses a Waiver of Right to Recover from Others, with specific considerations and limitations for states including California, Utah, Texas, Missouri, Kansas, Kentucky, New Hampshire, and New Jersey.
The endorsement provides a waiver of subrogation rights for any person or organization against whom MEDIMPACT HOLDINGS INC. has agreed to waive recovery rights in a written contract executed prior to the date of loss. The document outlines specific legal constraints and limitations, particularly for construction-related contracts in certain states. The policy allows for waiver of recovery rights, but with important caveats such as the requirement of a prior written contract and state-specific restrictions, particularly in states like Missouri and Kansas where construction-related contracts have additional regulatory considerations.
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Text version
WC 00 03 13 (11/05) © Copyright 1983–2017 National Council on Compensation Insurance, Inc. All Rights Reserved.
Workers' Compensation and Employers' Liability Policy Named Insured
MEDIMPACT HOLDINGS INC.
10181 SCRIPPS GATEWAY COURT
SAN DIEGO CA 92131
Endorsement Number
Policy Number
Symbol: RWC Number: (25)7184-00-64 Policy Period
04-30-2024 TO 04-30-2025
Effective Date of Endorsement 04-30-2024
Issued By (Name of Insurance Company)
ACE AMERICAN INSURANCE COMPANY
Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy.
This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated.
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 any one not named in the Schedule.
Schedule
ANY PERSON OR ORGANIZATION AGAINST WHOM YOU HAVE AGREED TO WAIVE YOUR
RIGHT OF RECOVERY IN A WRITTEN CONTRACT, PROVIDED SUCH CONTRACT WAS
EXECUTED PRIOR TO THE DATE OF LOSS.
For the states of CA, UT, TX, refer to state specific endorsements.
This endorsement is not applicable in KY, NH, and NJ.
The endorsement does not apply to policies in Missouri where the employer is in the construction group of code classifications. According to Section 287.150(6) of the Missouri statutes, a contractual provision purporting to waive subrogation rights against public policy and void where one party to the contract is an employer in the construction group of code classifications.
For Kansas, use of this endorsement is limited by the Kansas Fairness in Private Construction Contract Act(K.S.A..
16-1801 through 16-1807 and any amendments thereto) and the Kansas Fairness in Public Construction Contract Act(K.S.A 16-1901 through 16-1908 and any amendments thereto). According to the Acts a provision in a contract for private or public construction purporting to waive subrogation rights for losses or claims covered or paid by liability or workers compensation insurance shall be against public policy and shall be void and unenforceable except that, subject to the Acts, a contract may require waiver of subrogation for losses or claims paid by a consolidated or wrap-up insurance program.
Authorized Agent
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