American Association of State Compensation insurance Fund
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CopperPoint Mutual Insurance Company
Phone: (602) 631-2000
Address: 3030 North Third Street
Phoenix, AZ   85012
Website: www.copperpoint.com

State Compensation Insurance Fund
Phone: 888-STATEFUNDCA
Address: 333 Bush Street
Suite 800
San Francisco, CA   94104
Website: www.statefundca.com

Pinnacol Assurance
Phone: (303) 361-4000
Address: 7501 East Lowry Boulevard
Suite 800
Denver, CO   80230-7006
Website: www.pinnacol.com

Hawaii Employers' Mutual Insurance Co. Inc.
Phone: (808) 524-3642
Address: 1100 Alakea Street
Suite 1400
Honolulu, HI   96813
Website: www.hemic.com

Idaho State Insurance Fund
Phone: (208) 332-2100
Address: 1215 West State Street
P.O. Box 83720
Boise, ID   83720-0044
Website: www.idahosif.org

Kentucky Employers Mutual Insurance
Phone: (859) 425-7800
Address: 250 West Main Street Suite 900
P.O. Box 83720
Lexington, KY   40507-1724
Website: www.kemi.com

Louisiana Workers' Compensation Corporation
Phone: (225) 924-7788
Address: 2237 South Acadian Thruway
P.O. Box 83720
Baton Rouge, LA   70808
Website: www.lwcc.com

Maine Employers Mutual Insurance Company (MEMIC)
Phone: (207) 791-3300
Address: 261 Commercial Street
P.O. Box 11409
Portland, ME   04104
Website: www.memic.com

Chesapeake Employers’ Insurance Company
Phone: (410) 494-2000
Address: 8722 Loch Raven Boulevard
P.O. Box 11409
Towson, MD   21286-2235
Website: www.ceiwc.com

SFM Mutual Insurance Company
Phone: (952) 838-4200
Address: 3500 American Boulevard West Suite 700
P.O. Box 11409
Bloomington, MN   55431-4434
Website: www.sfmic.com

Missouri Employers Mutual Insurance
Phone: (800) 442-0590
Address: 101 N Keene St
P.O. Box 11409
Columbia, MO   65201
Website: www.mem-ins.com

Montana State Fund
Phone: (406) 495-5015
Address: 855 Front Street
P.O. Box 4759
Helena, MT   59604-4759
Website: www.montanastatefund.com

New Mexico Mutual Group
Phone: (505) 345-7260
Address: 3900 Singer Boulevard NE
P.O. Box 4759
Albuquerque, NM   87109
Website: www.newmexicomutual.com

New York State Insurance Fund
Phone: (212) 312-7001
Address: 199 Church Street
P.O. Box 4759
New York, NY   10007
Website: www.nysif.com

Workforce Safety and Insurance
Phone: (701) 328-3800
Address: 1600 East Century Avenue Suite 1
P.O. Box 4759
Bismarck, ND   58506-5585
Website: www.WorkforceSafety.com

Ohio Bureau of Workers Compensation
Phone: (800) 644-6292
Address: 30 West Spring Street
P.O. Box 4759
Columbus, OH   43215-2256
Website: www.ohiobwc.com

CompSource Mutual Insurance Company
Phone: (405) 232-7663
Address: 1901 North Walnut Ave.
P.O. Box 53505
Oklahoma City, OK   73152-3505
Website: www.compsourcemutual.com

State Accident Insurance Fund (SAIF)
Phone: (503) 373-8000
Address: 400 High Street SE
P.O. Box 53505
Salem, OR   97312-1000
Website: www.saif.com

Pennsylvania State Workers Insurance Fund
Phone: (570) 963-4635
Address: 100 Lackawanna Avenue
P.O. Box 5100
Scranton, PA   18505-5100
Website: www.dli.state.pa.us/swif

Beacon Mutual Insurance Company
Phone: (401) 825-2667
Address: One Beacon Centre
P.O. Box 5100
Warwick, RI   02886-1378
Website: www.beaconmutual.com

South Carolina State Accident Fund
Phone: (803) 896-5800
Address: P.O. Box 102100
P.O. Box 5100
Columbia, SC   29221-5000
Website: www.saf.sc.gov

Texas Mutual Insurance Company
Phone: (800) 859-5995
Address: 6210 East Highway 290
P.O. Box 5100
Austin, TX   78723-1098
Website: www.texasmutual.com

Workers Compensation Fund
Phone: (800) 446-2667
Address: 100 West Towne Ridge Parkway
P.O. Box 2227
Sandy, UT   84070
Website: www.wcfgroup.com

Washington Department of Labor and Industries
Phone: (360) 902-5800
Address: P.O. Box 44001
P.O. Box 2227
Olympia, WA   98504-4001
Website: www.lni.wa.gov

Wyoming Division of Workers Safety & Compensation
Phone: (307) 777-7159
Address: Cheyenne Business Center
1510 East Pershing Boulevard
Cheyenne, WY   82002
Website: wydoe.state.wy.us

Workers Compensation Board - Alberta
Phone: (780) 498-3999
Address: 9925-107 Street
P.O. Box 2415
Edmonton, AB   T5J 2S5
Website: www.wcb.ab.ca

Workers Compensation Board of British Columbia (WORKSAFEBC)
Phone: (604) 273-2266
Address: P.O. Box 5350 Station Terminal
P.O. Box 2415
Vancouver, BC   V6B 5L5
Website: www.worksafebc.com

Manitoba Workers Compensation Board
Phone: (204) 954-4321
Address: 333 Broadway
P.O. Box 2415
Winnipeg, MB   R3C 4W3
Website: www.wcb.mb.ca

WorkSafeNB
Phone: (506) 632-2200
Address: 1 Portland Street
P.O. Box 160
Saint John, NB   E2L 3X9
Website: www.worksafenb.ca

Workers Compensation Board of Nova Scotia
Phone: (902) 491-8999
Address: 5668 South Street
P.O. Box 1150
Halifax, NS   B3J 2Y2
Website: www.wcb.ns.ca

Prince Edward Island Workers Compensation Board
Phone: (902) 368-5680
Address: 14 Weymouth Street
P.O. Box 1150
Charlottetown, PE   C1A 7L7
Website: www.wcb.pe.ca

Saskatchewan Workers Compensation Board
Phone: (306) 787-4370
Address: 200 - 1881 Scarth Street
P.O. Box 1150
Regina, SK   S4P 4L1
Website: www.wcbsask.com

Puerto Rico State Insurance Fund Corporation
Phone: (787) 793-5959
Address: G.P.O. Box 365028
P.O. Box 1150
San Juan, PR   00936-5028
Website: www.cfse.gov.pr
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AASCIF Newsletter

Part Two/Type B Coverage – Real Protection, or Merely an Illusion?

Holly O'Dell, Managing Attorney at SAIF

Most of us are familiar with Part I (also called Coverage A) of a workers’ compensation insurance policy, which provides coverage for workers’ compensation claims. Part II of the policy (also called Coverage B) is a bit more mysterious. A basic understanding of Part II, and how it functions in application, is useful to help agents and policyholders navigate their coverage related to employers’ liability.

Part II is titled “Employers Liability Insurance.” Policyholders and agents, perhaps due in part to the name of the policy, frequently assume that the policy provides comprehensive protection in case of a lawsuit alleging employer’s liability or negligence. They may tender requests for defense accordingly, and the carrier is then in the position of reviewing the request to determine whether Part II applies. When examined more closely, Part II coverage requirements are actually quite narrowly tailored and coverage is limited to very specific situations.

When a policyholder presents a request for defense under Part II, the carrier’s first step is to carefully review the specifics of the lawsuit filed. The carrier will evaluate several factors:

1) Who is the defendant? For Part II to apply, the defendant usually must be the named insured on the policy. If the defendant is another entity, such as a parent company, or LLC members in their individual capacity, and the insured is involved only collaterally, coverage may not apply.

2) Who is the plaintiff? Part II usually covers only lawsuits related to injuries sustained by an employee of the named insured. If the injured worker was an employee of another entity, such as a subcontractor, and the insured was only an indirect employer, coverage may not apply.

3) What are the counts or allegations in the complaint? For Part II to apply, the claim must involve injury or death to the worker. The injury must arise out of and in the course of employment. The injury must have occurred during the policy period and in a state or territory covered by the policy.

If the tender of defense survives the test of these most basic Part II requirements (many do not), the complaint will be reviewed carefully to determine whether there is any allegation that may invoke coverage. Coverage is limited to liability related to the bodily injury to the employee. This includes:

(1) liability to a third party as a result of injury to the employee (extremely rare);

(2) loss of consortium;

(3) a consequential injury to a family member of the employee as a direct consequence of the employee’s injury (extremely rare); and

(4) a dual capacity claim (such as if the employer also manufactured the piece of equipment on which the worker was injured).

If the only allegation in the complaint relates to negligence of the employer related to the employee’s injury, the carrier may accept the tender of defense and move to dismiss the lawsuit, citing the exclusive remedy of workers' compensation. Often, perhaps to get around exclusive remedy, the plaintiff will allege an intentional act. At this point, the lengthy list of “Exclusions” to Part II coverage comes into play. If the bodily injury was caused by an intentional act (exact wording differs in some states), Part II does not provide coverage. The question, however, is an issue of fact for the jury, and remains unresolved at the outset of the case. If there is a “mixed bag” lawsuit, in that at least one allegation in the complaint would invoke coverage, and another allegation alleges an intentional act, the carrier may assume defense with a reservation of rights. If ultimately the exclusion applies, Part II will not cover the claim.

Because the Part II coverage is narrowly tailored and has many exclusions, most AASCIF members likely have a short list of claims on which they have actually made Part II payments. But the duty to defend under the coverage is broader than the duty to indemnify and requires at least an initial defense until the court determines whether the exclusive remedy applies or the claim is excluded under Part II.

While a compensable Part II claim is rare, the coverage does provide real protection. Especially for a policyholder facing a civil suit that needs someone to provide an initial defense.


 

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