AgdaPkt 2016-09-12 Closed and Joint SA PFA

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ENDORSEMENT NO. U-2 CSAC EXCESS INSURANCE AUTHORITY EXCESS WORKERS’ COMPENSATION CLARIFICATION OF COVERAGE AMENDATORY ENDORSEMENT A. It is understood and agreed that Definition VI. LOSS is deleted in its entirety and replaced by the following: VI.LOSS: The term loss shall mean only such amounts as are actually paid by the Covered Party as benefits under the applicable Workers’ Compensation Act, or in payment of amounts imposed upon the Covered Party by Employers’ Liability, in settlement of claims for such benefits or damages, or satisfaction of awards or judgments for such benefits and damages, including court costs, interest upon awards or judgments, and allocated investigation, adjustment and legal expenses, but the term loss shall not include as expenses, salaries paid to employees of the Covered Party, nor fees and retainers paid to any service organization. Notwithstanding the foregoing, loss does not include any amounts paid by the Covered Party as benefits, or in payment of amounts imposed upon the Covered Party by Employers’ Liability, deriving solely from any Covered Party’s enactment, resolution or other act establishing either a presumption of work- related illness or injury or any other expansion of benefits beyond those prescribed by the applicable Workers’ Compensation Act. Despite any such enactment resolution or act, the Covered Party shall retain the burden of establishing loss within the Memorandum of Coverage. It is further agreed that nothing herein shall act to increase the Authority’s limit of indemnity. This endorsement is part of the Memorandum of Coverage and takes effect on the effective date of the Memorandum of Coverage unless another effective date is shown below. All other terms and conditions remain unchanged. Effective Date: Memorandum No.: EIA 15 EWC-00 Issued to: ALL MEMBERS Issue Date: June 26, 2015 Authorized Representative CSAC Excess Insurance Authority 6.1.C. - Page 61