XXIII UNIVERSAL STANDARD WORKMEN'S COMPENSATION POLICY (Hereinafter called the Company) HEREBY AGREES WITH THE ASSURED Named in the Declarations attached hereto and forming part hereof, as respects personal injury sustained by employes, including death at any time resulting therefrom, One. (a) To Pay Promptly to any person entitled thereto, under the Workmen's Compensation Law and in the manner therein provided, the entire amount of any sum due, and all installments thereof as they become due, S To such person because of the obligation for compensation for any such injury imposed upon or accepted by this Employer under such of certain statutes, as may be applicable thereto, cited and described in an endorsement attached to this Policy, each of which statutes is herein referred to as the Workmen's Compensation Law, and (2) For the benefit of such person the proper cost of whatever medical, surgical, nurse or hospital services medical or surgical apparatus or appliances and medicines, or, in the event of fatal injury, whatever funeta expenses are required by the provisions of such Workmen's Compensation Law. It is agreed that all of the provisions of each Workmen's Compensation Law covered hereby shall be and remain a part of this contract as fully and completely as if written herein, so far as they apply to compensation or other benefits for any personal injury or death covered by this Policy, while this Policy shall emain in force. Nothing herein contained shall operate to so extend this Policy as to include within its terms anWorker's Compensation Law, scheme or plan not cited in an endorsement hereto attached. One. (b) To Indemnify this Employer against loss by reason of the ability imposed upon him by law for damages on account of such injuries to such of said employes as are legall employed wherever such injuries may be sustained within the territorial limits of the United States of America or Dominion of Canada. In the event of the bankruptcy or insolvency of this Employer the Company shall ndye reeked from the payment of such indemnity hereunder as would have been payable but for such bankryptoy or insolvency. If, because of such bankruptcy or insolvency, an execution against this Employer is returned unsatisfied in an action brought by the injured, or by another person claiming by, through or under the injured, than an action may be maintained by the injured, or by such other person claiming by, through or under the injured, against the Company under the terms of this Policy for the amount of the judgment in said action not exceeding the amount of this Policy. Two. To Serve this Employer (a) by the inspection of work places covered by the Policy when and as deemed desirable by the Company and thereupon to suggest to this Employer such changes or improvements as may operate to reduce the number or severity of injuries ung work, and, (b) upon notice of such injuries, by. investigation thereof and by settlement of any resulting insinccordance with law. Three. To Defend, in the name and on behalf of this Employer, any suits or other proceedings which may at any time be instituted again Dhim an ccount of such injuries, including suits or other proceedings alleging such injuries and demanding damage or compensation therefor, although such suits, other proceedings, allegations or demands are wholly groundless, false or fraudulent. Four. To Pay at costs taxed against this Employer in any legal proceeding defended by the Company, all interest accruing after ( judgment and all expenses incurred by the Company for investigation, negotiation or defense. Five. This agreement shall apply to such injuries sustained by any person or persons employed by this Employer whose one remuneration shall be included in the total actual remuneration for which provision is hereinafter made, upon which remuneration the premium for this Policy is to be computed and adjusted, and, also to such injuries so sustained by the President, any Vice-President, Secretary or Treasurer of this Employer, if a corporation. The remuneration of any such designated officer shall not be subjected to a premium charge unless he is actually performing such duties as are ordinarily undertaken by a superintendent, foreman or workman. Six. This agreement shall apply to such. injuries so sustained by reason of the business operations described in said Declarations which, for the purpose of this insurance, shall include all operations necessary, incident or appurtenant thereto, or connected therewith, whether such operations are conducted at the work places defined and described in said Declarations or elsewhere in connection with, or in relation to, such work places. Seven. This agreement shall apply only to such injuries so sustained by reason of accidents occurring during the Policy period limited and defined as such in Item 2 of said Declarations. THIS AGREEMENT IS SUBJECT TO THE FOLLOWING CONDITIONS: A. The premium is based upon the entire remuneration earned, during the Policy period, by all employes of this Employer engaged in the business operations described in said Declarations together with all operations necessary, incident or appurtenant thereto, or connected therewith whether conducted at such work places or elsewhere in connection therewith or in relation thereto; excepting however the remuneration of the President, any VicePresident, Secretary or Treasurer of this Employer, if a corporation, but including the remuneration of any one or more of such designated officers who are actually performing such duties as are ordinarily undertaken by a superintendent, foreman or workman. If any operations as above defined are undertaken by this Employer but are not described or rated in said Declarations, this Employer agrees to pay the premium thereon, at the time of the final adjustment of the premium in accordance with Condition C hereof, at the rates, and in compliance with the rules, of the Manual of Rates in use by the Company upon the date of issue of this Policy. At the end of the Policy period the actual amount of the remuneration earned by employes during such period shall be exhibited to the Company, as provided in Condition C hereof, and the earned premium adjusted in accordance therewith at the rates and under the conditions herein specified. If the earned premium, thus computed, is greater than the advance premium paid, this Employer shall immediately pay the additional amount to the Company, if less, the Company shall return to this. Employer the unearned portion, but in any event the Company shall retain the Minimum Premium stated in said Declarations. All premiums provided by this Policy, or by any endorsement hereon,, shall be fully earned whether any such Workmen's Compensation Law, or any part of such, is now or shall hereafter be declared invalid or unconstitutional. B. This Policy may be cancelled at any time by either of the parties upon written notice to the other party stating XXIII-Continued when, not less than ten days thereafter, cancellation shall be effective. The effective date of such cancellation shall then be the end of the Policy period. The law of any state, in which this Policy applies, which requires that notice of cancellation shall be given to any Board, Commission or other state agency is hereby made a part of this Policy and cancellation in such state shall not be effective except in compliance with such law. The remuneration of employes for the Policy period stated in said Declarations shall be computed upon the basis of the actual remuneration to the date of cancellation determined as herein provided. If such cancellation is at the Company's request, the earned premium shall be adjusted pro rata as provided in Condition A. If such cancellation is at this Employer's request, the earned premium shall be computed and adjusted at short rates, in accordance with the table printed hereon, but such short rate premium shall not be less than the Minimum Premium stated in said Declarations. If this Employer when requesting cancellation is actually retiring from the business herein described, then the earned premium shall be computed and adjusted pro rata. Notice of cancellation shall be served upon this Employer as the law requires, but, if no different requirement, notice mailed to the address of this Employer herein given shall be a sufficient notice, and the check of the Company, similarly mailed, a sufficient tender of any unearned premium. C. The Company shall be permitted, at all reasonable times during the Policy period, to inspect the plants, works. machinery and appliances covered by this Policy, and to examine this Employer's books at any time during the Policy period, and any extension thereof, and within one year after its final expiration, so far as they relate to the remuneration earned by any employes of this Employer while this Policy was in force. D. The obligations of Paragraph One (a) foregoing are hereby declared to be the direct obligations and promises of the Company to any injured employe covered hereby, or, in the event of his death, to his dependents; and to each such employe or such dependent the Company is hereby made directly and primarily liable under said obligations and promises. This contract is made for the benefit of such employes or such dependents and is enforceable against the Company, by any such employe or such dependent in his name or on his behalf, at any time and in any manner permitted by law, whether claims or proceedings are brought against the Company alone or jointly with this Employer. If the law of any state in which the Policy is applicable provides for the enforcement of the rights of such employes or such dependents by any Commission, Board or other state agency for the benefit of such employes or such dependents, then the provisions of such law are made a part hereof, as respects any matter subject thereto, as fully as if written herein. The obligations and promises of the Company as set forth in this paragraph shall not be affected by the failure of this Employer to do or refrain from doing any act required by the Policy; nor by any default of this Employer after the accident in the payment of premiums or in the giving of any notice required by the Policy or otherwise; nor by the death, insolvency, bankruptcy, legal incapacity or inability of this Employer, nor by any proceeding against him as a result of which the conduct of this Employer's business may be and continue to be in charge of an executor, administrator, receiver, trustee, assignee, or other person. E. As between the employe and the Company, notice to or knowledge of this Employer of an injury or death covered hereby shall be notice or knowledge, as the case may be, of the Company; the jurisdiction of this Employer for the purposes of any Workmen's Compensation Law covered hereby shall be jurisdiction of the Company and the Company shi in all things be bound by and subject to the findings, judgments, awards, decrees, orders or decisior rendered against this Employer in the form and manner provided by such laws and within the terms, limitations and provisions of this Policy not inconsistent with such laws. F. This Employer, upon the occurrence of an accident, shall give immediate written notice thereof to the Company with the fullest information obtainable. He shall give like notice with full particulars of any claim made on account of such accident. If, thereafter, any suit or other proceeding is instituted against this Employer, he shall immediately forward to the Company every summons, notice or other process served upon him. Nothing elsewhere contained in this Policy shall relieve this Employer of his obligations to the Company with respect to notice as herein imposed upon him. G. No action shall lie against the Company to recover upon any claim or for any loss under Paragraph One (b) foregoing unless brought after the amount of such claim or loss shall have been fixed and rendered certain either by final judgment against this Employer after trial of the issue or by agreement between the parties with the written consent of the Company, nor in any event unless brought within two years thereafter. 'H. If the method of serving notice of cancellation, or the limit of time for notice of accident or for any legal proceeding herein contained is at variance with any specific statutory provision in relation thereto, in force in the state in which any of the business operations herein described are conducted, such specific statutory provision shall supersede any such condition in this contract inconsistent therewith. I. No assignment of interest under this Policy shall bind the Company unless the consent of the Company shall be endorsed hereon. J. If this Employer carries any other insurance covering a claim covered by this Policy, he shall not recover from the Company a larger proportion of any such claim than the sum hereby insured bears to the whole amount of valid and collectible insurance. K. The Company shall be subrogated in case of any payment under this Policy, to the extent of such payment, to all rights of recovery therefor vested by law either in this Employer, or in any employe or his dependents claiming hereunder, against persons, corporations, associ ations or estates. L. No condition or provision of this Policy shall be waived or altered except by endorsement attached hereto signed by the President, a Vice-President, Secretary or an Assistant Secretary of the Company, nor shall notice to any agent, nor shall knowledge possessed by any agent, or by any other person, be held to effect a waiver or change in any part of this contract. Changes in the written portion of the Declarations forming a part hereof (except Items 2, 3 and 4) may be made by the agent countersigning this Policy, such changes binding the Company when initialed by such agent. The personal pronoun herein used to refer to this Employer or to an injured employe or dependents, shall apply regardless of number or gender. M. The statements in Items 1 to 6 inclusive in the Declarations hereinafter contained, are true; those stated as estimates only are believed to be true. This Policy is issued upon such statements and in consideration of the provisions of the Policy respecting its premium and the payment of the premium in such Declarations expressed. XXV SAMPLE RATE SHEET OF COMPENSATION MANUAL NEW JERSEY. RATE SHEET. The COMPENSATION RATES and MINIMUM PREMIUMS for this State are shown below opposite the CODE NUMBERS of the various classifications. NOTE: Symbol (a) means "refer to Home Office." Code 0100.. 2.18.. 26.1640.. 2.92.. 34. 2091.. .90.. 13. 2349.. 1.28.. 17. 0101.. 2.18.. 26. 1654.. 3.86.. 42.2092.. .90.. 13. 2350.. 0251.. .95.. 14. 1701.. 1.76.. 22. 2101.. 1.18.. 16. 2351.. 0301.. 1.39.. 18. 1703.. 1.59.. 20. 2102.. .87.. 13. 2361.. 0302.. 2.32.. 27. 1710.. 3.13.. 36. 2105.. .54.. 9.2362.. .78.. 12. .61.. 10. .19.. 6. .36..' 8. 0400.. 1.58.. 20. 1741.. 1.59.. 20. 2110.. 1.35.. 18. 2380.. 0401.. 3.24.. 36. 1742.. 1.59.. 20. 2111.. 1743.. 1.59.. 20. 1102.. 2.78.. 32. 1744.. 1.59. 20. 2112.. 1120.. 4.38.. 48. 1745.. .74.. 11. 2114.. .32.. 1.00.. 14. 2382.. .32.. .75.. 12. 2384.. .30.. 7. .32.. 7. .30.. 7. .32.. 7. .62.. 10. 1121.. 4.38.. 48.1748.. .65.. 11. 2121.. 1.52.. 19. 2387.. 1154.. 6.36.. 70. 1750.. 1.79.. 22. 2125.. 1.52.. 19. 2388.. 1802.. 1.27.. 17. 2130.. 1.72.. 21.2390.. 1164.. 3.56.. 40. 1803.. 1.27.. 17. 2143.. 1.35.. 18. 2402.. 1165.. 3.56.. 40. 1852.. 1.24.. 16. 2150.. 2.00.. 24. 2410.. 1.4S.. 19. .82.. 12. .82.. 12. S. 2416.. .53.. 9. 1200.. 2.51.. 29. 1853.. .74.. 11. 2161.. 2.43.. 28. 2413.. 1201.. 4.74.. 50. 1860.. .82.. 12. 2173.41.. 1859.. .78.. 12. 2165.. 1.35.. 18. 2415.. 1217.. 3.67.. 40. 1924.. 1.38.. 18. 2174.. 4.76.. 50. 2417...75.. 12. 1301.. 1.24.. 16. 2000.. 1.11.. 15. 2175.. .41.. S. 2501...21.. 1321.. 2.88.. 32. 2001...1.11.. 15. 2176.. .11.. 6. 2502.. 1410.. .83. 12. 2002.. 2.29.. 27. 2210.. 3.07.. 34. 2503.. 2014.. 1.42.. 18. 2211.. 1.41.. 18. 2520.. 1413.. 1.22.. 16. 2015.. 1.24.. 16. 2216.. 2.48.. 29. 2521.. 1420.. 2.51.. 29. 2016.. 1.11.. 15. 2220.. .21.. 6. .21.. 6. 6. 1421.. 3.63.. 40. 2020.. .99.. 14.2222. 1465.. 1.79.. 22. 2012.. 1470.. 1.72.. 21: 2045.. .81.. 12. 2280. .81.. 12. 2286.. 2054.. .61.. 10. 22SS.. 1471.. 2.16.. 26. 2061.. 1.18.. 16. 2291.. 1472.. 1.54.. 19. 2062.. 1.18.. 16. 2300.. |