CISR Commercial Casualty II key terms

The legal principle that an injured employee's only recovery from the employer for a work-related injury is the statutory workers' compensation benefit, barring a tort suit against that employer.

The wage replacement, medical, disability, and death benefits an employer must provide under the state workers' compensation statute, regardless of fault.

The section of the standard workers' compensation and employers' liability policy that pays whatever benefits the insured employer is legally obligated to pay under the applicable state statute.

Coverage for the employer's liability to employees for work-related bodily injury outside the statutory benefit system, such as third-party-over or loss-of-consortium claims, subject to stated limits.

An optional part of the workers' compensation policy that extends benefits to employees working temporarily in states not specifically listed in Item 3.A of the declarations, if the insured has not secured other coverage there.

The exposure measure used to price workers' compensation coverage, typically each $100 of payroll multiplied by a classification rate that reflects the hazards of the employee's work.

A multiplier applied to manual workers' compensation premium that credits or debits an employer's loss experience relative to other employers in the same classification.

The job-category code assigned to a worker's duties for workers' compensation rating, reflecting the relative hazard of that work rather than the employer's overall business type.

The post-policy-period review of the insured's payroll records to determine the final workers' compensation premium, since estimated payrolls at inception are rarely exact.

The geographic area in which a policy applies; under workers' compensation it is defined by the states listed on the declarations plus any states covered by Part Three.

A state-run insurance program that is the only permitted source of workers' compensation coverage for employers in that state, so private carriers cannot write the statutory benefit.

An endorsement, used where a state fund or monopolistic fund provides statutory benefits, that adds employers' liability protection for that state to the policy.

Federal law giving seamen a negligence remedy against their employer for work-related injury, which is typically addressed by a maritime endorsement rather than standard workers' compensation coverage.

Federal statute providing benefits to maritime workers injured on navigable waters or adjoining areas, with coverage often added to a workers' compensation policy by endorsement.

An endorsement naming a second entity as an insured for workers' compensation purposes, often used for employee leasing arrangements or joint ventures with shared worksite control.

An endorsement by which the workers' compensation carrier gives up its right to recover benefit payments from a third party who caused the injury, usually to satisfy a contractual requirement.

A policy condition that determines how multiple policies covering the same loss share payment, using methods such as primary, excess, or contribution by equal shares.

The standard policy form that insures liability and physical damage arising from the ownership, maintenance, or use of autos in the insured's business, with coverage triggered by symbols entered on the declarations.

A numbered designation on the business auto declarations that identifies which autos or categories of autos the liability coverage applies to, such as owned autos only or hired and non-owned autos.

As defined in the business auto form, a land motor vehicle, trailer, or semitrailer designed for travel on public roads, including certain attached equipment; mobile equipment is generally excluded.

Vehicles such as bulldozers, forklifts, and farm machinery that are not subject to motor vehicle registration and are therefore not autos; liability for them falls under general liability, not auto coverage.

An auto the insured leases, hires, rents, or borrows for business use, other than from an employee; liability for such autos can be covered by selecting the appropriate symbol.

An auto used in the insured's business but not owned, leased, hired, rented, or borrowed by the insured, such as an employee's personal car used on company errands.

The broadest covered auto designation, applying liability coverage to all autos, whether owned, hired, borrowed, or non-owned, used in the insured's business.

A covered auto designation that limits liability and physical damage coverage to only the autos individually listed on the schedule of covered autos.

An individual vehicle identified on the policy by year, make, model, and vehicle identification number, typically used when physical damage coverage is written.

Business auto coverage that pays for damage to a covered auto from collision or from causes other than collision, such as fire, theft, vandalism, or weather.

Physical damage coverage for loss caused by the impact of the covered auto with another object or by overturn, including single-vehicle accidents.

Physical damage coverage for losses such as fire, theft, larceny, explosion, earthquake, windstorm, hail, water, flood, vandalism, malicious mischief, or glass breakage.

An endorsement extending liability, and sometimes physical damage, coverage to a named individual while driving autos the business does not own, hire, or borrow, often for executives with company cars.

The business auto exclusion barring liability coverage for damage to property in the insured's care, custody, or control, such as a customer's vehicle being serviced.

Coverage, often written with garage and auto service risks, for damage to customers' autos left in the insured's care while the insured is providing parking or repair services.

An alternative to the business auto form for trucking and hauling operations, using similar symbols but adding coverage for trailers in transit and for leased owner-operators.

A state statute requiring drivers or motor carriers to demonstrate the ability to pay for injuries or damage they cause, usually through liability insurance with minimum limits.

A liability limit structure stated as three amounts, such as 250/500/100, representing per-person bodily injury, per-accident bodily injury, and property damage limits.

A liability limit stated as one total amount that applies to all bodily injury and property damage arising from a single accident, without per-person sublimits.

A policy providing liability limits above the insured's underlying auto, general liability, and employers' liability policies, and sometimes dropping down to cover gaps in those underlying coverages.

Liability protection that responds only after the limits of specified underlying policies are exhausted, and generally follows the terms of those underlying policies.

The limits of the scheduled primary policies that must be exhausted before umbrella or excess coverage responds; the umbrella schedule lists each required policy and limit.

The amount the insured must pay out of pocket for a covered loss before umbrella coverage responds, typically applied when no underlying policy covers the loss or the insured retains the risk.

Umbrella protection that responds to a loss not covered by a required underlying policy, or where the underlying limit is lower than the umbrella's required limit, subject to the self-insured retention.

A policy that provides limits above scheduled underlying policies and follows the terms of those policies without broadening coverage, unlike a true umbrella.

The principle that excess or umbrella coverage adopts the definitions, exclusions, and conditions of the underlying policy, so the higher layer responds as the primary would.

The umbrella requirement that the insured keep the scheduled underlying policies in force at or above the required limits; failure can reduce or bar umbrella recovery.

The maximum an insurer will pay for all covered losses during a policy period, which applies to umbrella and excess liability coverage in addition to the per-occurrence limit.

The maximum an insurer will pay for all damages arising out of a single accident or occurrence, regardless of the number of claimants or claims.