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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, O11 . -U ::I g, ctry 3 s 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 .a i 0 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 ® n 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 .r 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 0 0 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 ay � " "- � � SI - Authorized Representative / OENT STATECOMPENSAT ON INSURANICE FUND 525 GOLDEN GATE AVE,- SAN FRANCISCO, CALIFORNIA 94102 ® v 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 ® v 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