CTR077453_COI_2.pdf

This document is a Workers Compensation and Employers Liability Insurance Policy Waiver of Right to Recover from Others Endorsement issued by AmTrust Insurance Company for Casa D'Amore Family Care LLC. The policy is dated 8/21/2024, with a policy number KWC1363924 and an endorsement number of 0. The document outlines an insurance endorsement that modifies the standard workers compensation policy by limiting the insurer's right to recover payments from certain parties as specified in a written contract.

The endorsement includes a premium of $10,739 and provides a waiver that prevents the insurance company from pursuing recovery against any person or organization as required by a written contract. The Schedule section broadly defines the covered parties as "Any person or organization as required by written contract," which suggests flexibility in application across different contractual arrangements. The endorsement is specifically designed to modify the standard workers compensation policy's subrogation rights, effectively protecting designated parties from potential recovery efforts by the insurance carrier in the event of a covered injury.