HomeMy WebLinkAboutC-1543 - Excess insurance coverage in connection with City's Workmen's CompensationCITY OF NEWPORT BEACH
CALIFORNIA
City Hall
3300 W. Newport Blvd.
Area Code 714
673 -2110
DATE July 31, 1973
TO: FINANCE DIRECTOR
FROM: City Clerk
SUBJECT: Contract No. C -1543
Ebmess
Description of Contract Workmm's Omwmatim /Insurance Policy
Authorized by Resolution No. 8027 , adopted on 6 -25-73
Effective date of Contract July 21, 1973
Contract with State Cmgmsation Insurance FUnd
Address 525 Golden Gate Avenue
San FYemcisoo. CA 94102
Amount of Contract gam+ cmtra t
city tie
City Clerk
July 12. 1913
,City Attorney
Attn: I:'ave iaade
City Mark
Enclosed is ore executed copy of the uninsured workmen's compensation
consultant agreement with Fred S. James Company and one executed
copy of thq -,*ata Compensation Insurance Fund Policy Agreement,. )le-
City Clerk
LL:dg
Encl.
STATE • !
FUND
2M FAST FOURTH STREET - SANTA ANA. CALIFORNIA
TELEPHONE 79,
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NfwPOLI Bf 1
CALIF Acy
June 20, 1973
Mr. Frank Ivens
Assistant to the City Manager
City of Newport Beach 9376
3300 Newport Blvd.
Newport Beach, California 92660
Dear Mr. Ivens
This letter acknowledges receipt of your correspondence
dated June 18, 1973 to State Compensation Insurance Fund
asking State Fund to write workmen's compensation excess
insurance coverage at $100,000 retention level for the
City of Newport Beach. The excess insurance will be
provided at the rate specified in our quote dated May 29,
1973, for the excess coverage without State Fund adjusting
claims, for the policy period July 1, 1973 to July 1, 1974.
We are pleased to be able to provide protection against
excessive catastrophic losses for the City of Newport
Beach.
Sincerely
, &14 ----
c
Jak Webb
District Manager
PFM: ldj
cc Mr. Walt Schulz, Underwriting
MAIL AOCRESS. BOX 419 - SANTA ANA. CALIFORNIA 92702
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WORKMEN'S COMPENSATION EXCESS INSURANCE POLICY
STATE COMPENSATION INSURANCE FUND
OF THE
STATE OF CALIFORNIA
(Herein called the Fund)
The State Compensation Insurance Fund and the insured mutually
agree to the terms, conditions, and limitations of this policy
as follows:
INSURING AGREEMENT
I. WORKMEN'S COMPENSATION AND EMPLOYERS' LIABILITY
The Fund hereby agrees to indemnify the insured against
excess loss which the insured shall become obligated to
pay on account of:
a. Compensation required of the insured by the Workmen's
Compensation Laws of the State of California; and
b. Damages imposed as the result of suits filed against
the insured as an employer under the laws of the
State of California by employees covered by this
policy on account of bodily injuries or occupational
diseases, including death therefrom.
II. LIMIT OF INDEMNITY AND RETENTION
The Fund's liability shall be for the amount in excess
of the retention and up to the limit of indemnity as
stated in this policy, provided that the retention and
limit of indemnity shall apply:
a. To bodily injury or death sustained by one or more
employees in each accident, and
b. Separately as to bodily injury or death caused by
occupational disease sustained by each employee.
III. INDEMNIFICATION
a. For excess loss as provided for elsewhere in this
policy.
b. For allocated expenses in the same proportion as the
loss ultimately borne by the Fund is to the total
loss, providing that this provision shall apply to
appeals from decisions of the Workmen's Compensation
Appeals Board, or any court, only if the Fund agrees
in advance of the filing of the appeal.
STATECOMPENSAT ON
INSURANICE FUND
525 GOLDEN GATE AVE. - SAN FRANCISCO, CALIFORNIA 94102
Page 2 of 5
• •
C. Indemnification for expenses under Section III.(b),
above, is in addition to the retention and limit of
indemnity provided by this policy.
J. Loss shall mean actual payments in money for benefits
as provided for in Section I, parts (a) and (b) of
this policy.
e. "Allocated expenses" shall mean actual court costs,
legal and allocated investigation expenses.
f. Loss and allocated expenses shall not include salaries
of insured's employees, expenses of adjusting claims
or expenses of claims adjusting agencies.
EXCLUSIONS
This policy does not apply as respects Section I, part (b) of
the Insurance Agreement to liability assumed by the insured under
any written, oral, or implied contract or agreement.
CONDITIONS
I. PREMIUM AND AUDIT
a. Premium shall be determined at the rates shown in the
policy and shall be based upon the entire remuneration
earned during the policy period by all employees. The
insured agrees to maintain accurate records of the
remuneration and to make such records available for
examination and audit by the Fund.
b. The premium stated in the declarations is an estimated
premium. When earned premium exceeds the premium paid,
the insured agrees to pay the difference to the Fund;
when less, the Fund shall return the difference to the
insured. The earned premium shall be the minimum premium
for this policy.
II. REIMBURSEMENT
The insured agrees to provide a statement of expenditures
for each claim covered by this policy. Proof of payment
may be required by the Fund. Such statement shall be
presented not less than four times per year and shall
indicate the reason for each payment. The Fund shall make
prompt reimbursement to the insured.
Ill. CLAIMS ADMINISTRATION
The insured agrees to investigate and settle all claims
STATE CNSURANICE FUND
525 GOLDEN GATE AVE. - SAN FRANCISCO, CALIFORNIA 94102
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Page 3 of 5
and to conduct the defense and appeal in all actions, suits,
and proceedings commenced against it, and shall give prompt
notice to the Fund of:
a. Any action or suit commenced against the insured; and
any proceeding, event, or development which might result
in a claim upon the Fund; and
b. Shall forward promptly to the Fund copies of pleadings
and reports of investigation; and other information or
documents requested by the Fund.
The Fund, at its own election and expense, shall have the
right to participate with the insured in the defense or
appeal of any action, suit, or proceeding in which the Fund
deems it may become involved.
The insured agrees not to make any voluntary settlement
involving loss to the Fund except with the written consent
of the Fund.
The insured agrees to give written notice to the Fund of
any claim which may eventually require indemnification. In
addition, the insured agrees to notify and to keep the Fund
informed as respects each claim:
a. When the expected cost equals one -half the retention.
b. When monies paid out reach one -half the retention.
C. Involving paraplegics, quadriplegics, severe head
injuries, bilateral amputations or blindness.
The insured agrees to effectively pursue all subrogation
and salvage rights it may have growing out of the claim
as it deems appropriate.
The Fund may at all reasonable times examine the books and
records of the insured as respects all workmen's compensation
insurance claims; but the Fund waives no rights and undertakes
no responsibility by reason of such examination or the
omission thereof.
IV. OTHER INSURANCE
If the insured has other excess insurance, reinsurance, or
indemnity against a loss covered by this policy, the Fund
shall not be liable to the insured hereunder for a greater
proportion of such loss than the amount which would have
been payable under this policy, had no such other excess
insurance, reinsurance, or indemnity against loss existed,
STATE CNSURANICE FUND
525 GOLDEN GATE AVE. - SAN FRANCISCO, CALIFORNIA 90102
n
Page 4 of 5
• •
bears to the sum of said amount and the amounts which would
have been payable under each other policy applicable to sudh
loss, had each such policy been the only policy so applicable.
V. SUBROGATION AND SALV
The insured agrees to prosecute all claims it may have
against any person or entity which result, or may result,
in the payment of loss by the Fund. If the insured makes
recovery, such recovery shall first be applied against
indemnity and expenses paid by the Fund on account of the
claim or claims involved in the subrogation or salvage.
If the insured does not prosecute any such claim within a
reasonable time, the Fund shall be subrogated to such claim;
and the insured agrees to execute any and all papers and
documents necessary to vest full right, title, and interest
in said claim; and the Fund may prosecute said claim in its
own name or in the name of the insured. The insured agrees
to cooperate to the fullest extent with the Fund in the
enforcement of any such claim. The net proceeds derived
from such claim shall first be used by the Fund to.pay its
loss and expenses, and any remainder shall be paid to the
insured.
VI. CHANGES
Notice to any representative of the Fund or knowledge
possessed by any representative of the Fund or by any other
person shall not effect a waiver or a change in any part of
this policy or estop the Fund from asserting any right under
the terms of this policy; nor shall the terms of this policy
be waived or changed, except by endorsement issued to form
a part of this policy, signed by a duly authorized repre-
sentative of the Fund.
VII. ASSIGNMENT
The interest of the insured in this policy cannot be assigned.
VIII. CANCELLATION
This policy may be cancelled by either party at any time upon
written notice mailed to the other stating when, not less
than 30 days after the date of the notice, cancellation shall
be effective. If cancelled, the earned premium shall be
computed upon the entire remuneration of all employees for
the period of time the policy was in effect.
STATE CNSURANICE FUND
525 GOLDEN GATE AVE.- SAN FRANCISCO, CALIFORNIA 94102
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Page 5 of 5
IX. THE CONTRACT
This policy, including the declarations, and all endorse-
ments or riders hereon, constitutes the entire contract
of insurance. No condition, provision, agreement, or
understanding not set forth in the policy or in such
declarations, endorsements, or riders shall affect such
contract or any rights, duties, or privileges arising
therefrom.
STATECOMPENSAT ON
INSURANIGE FUND
525 GOLDEN GATE AVE.- SAN FRANCISCO, CALIFORNIA 94102
6a
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DECLARATIONS
POLICY NO.: XS 734 -73
NAME OF INSURED: CITY OF NEWPORT BEACH
ADDRESS: 3300 NEWPORT BOULEVARD, NEWPORT BEACH,'CALIFORNIA 92660
As a condition precedent, this policy is null and void unless the total
initial premium stated herein is tendered to the Fund on or before
JULY 21, 1973 at 12:01 A.M. standard time.
The period during which this policy shall remain in force, unless
cancelled, shall be from JULY 11 1973 at 12:01 A.M. standard
time to JULY 1, 1974 at 12:01 A.M. standard time.
LIMIT OF INDEMNITY: $10,00.0.,.000.. OVER $100.,.000.. RETAINED BY INSURED
INITIAL PREMIUM: $3,200.. ADJUSTMENT: SEMI ANNUAL BILL
In witness whereof, the State Compensation Insurance Fund has caused
this policy to be signed by its President but the same shall not be -
binding upon the Fund unless countersigned by a duly authorized officer
or representative of the Fund.
Countersigned at San Francisco, this date June 20, 1973
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" "- � � SI -
Authorized Representative / OENT
STATECOMPENSAT ON
INSURANICE FUND
525 GOLDEN GATE AVE,- SAN FRANCISCO, CALIFORNIA 94102
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ESTIMATED PAYROLL
RATE PER $100
PAYROLL
ESTIMATED ANNUAL
PREMIUM
$7,393,000
$0.0872
$6,446.70
In witness whereof, the State Compensation Insurance Fund has caused
this policy to be signed by its President but the same shall not be -
binding upon the Fund unless countersigned by a duly authorized officer
or representative of the Fund.
Countersigned at San Francisco, this date June 20, 1973
ay �
" "- � � SI -
Authorized Representative / OENT
STATECOMPENSAT ON
INSURANICE FUND
525 GOLDEN GATE AVE,- SAN FRANCISCO, CALIFORNIA 94102
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ATTEST:
/'
ity Clerk
APPROVED AS TO FORM:
Assistant City Attorney
CITY OF NEWPORT BEACH
RESOLUTION NO. 8 O 2
A RESOLUTION OF THE CITY COUNCIL
OF \�,IPORT BEACH AUTHORIZING THE
OF FA-' AGREEMENT BETWEEN THE CITY
BEACH AND THE STATE COMPENSATION
FUND TO PROVIDE EXCESS INSURANCE
CONNECTION WITH THE CITY'S WORK4
SATIO`+ INSURANCE PROGRAM
OF THE CITY
EXECUTION
OF NEWPORT
INSURANCE
COVERAGE IN
sN'S COMPEN-
WHER?`LS, there has been presented to the City Council
of the City of Newport Beach a certain agreement between the
City of Newport Beach and the State Compensation Fund to
provide excess insurance coverage in connection with the
City's Workmen's Compensation Insurance Program; and
WHEREAS, the City Council has considered the terms
and conditions of said agreement and found them to be fair and
equitable;
NOW, THEREFORE, BE IT RESOLVED that said agreement
is approved, and the Mayor and City Clerk are hereby author-
ized and directed to execute the same on behalf of the City
of Newport Beach.
ADOPTED this 25th day of June, 1973.
Mayor
ATTEST:
City Clerk
DON:sh
6/21/73