THE OHIO STATE TROOPERS ASSOCIATION CRIMINAL DEFENSE LEGAL EXPENSE REIMBURSEMENT INSURANCE POLICY

Transcription

1 THE OHIO STATE TROOPERS ASSOCIATION CRIMINAL DEFENSE LEGAL EXPENSE REIMBURSEMENT INSURANCE POLICY I. BENEFITS 1) In consideration of the premium specified on the Declaration Page forming part of this Master Policy, Underwriters agree, subject to the terms, conditions, definitions and exclusions appearing herein, to reimburse the Insured Member for any Legal Expense incurred by the Insured Member arising out of an Insured Event Instituted against the Insured Member during the Policy Period. There is no coverage for loss for any judgments, settlements, fines or monetary damages. 2) The Maximum Legal Expense reimbursable, the Deductible and Coinsurance hereunder shall be as shown on the Declaration Page. Underwriters shall reimburse the Insured Member sixty-five percent (65%) of any Legal Expense covered by this Policy, excess of the Deductible, up to the Maximum Legal Expense, with the Insured Member assuming thirty-five percent (35%) as Coinsurance. 3) The Maximum Legal Expense for Insured Members shall be $50,000 per Insured Event and in the aggregate. 4) Underwriters do not assume any duty to defend the Insured Member under this Policy. II. CONDITIONS 1) Any and all Appeals shall be considered to be part of the underlying Insured Event and treated as a single Insured Event. All matters arising out of the same events or circumstances shall be treated as a single Insured Event. 2) A Claims Notification period of twenty-one (21) days from the date of Institution of the Insured Event shall exist as a condition precedent to payment of any benefit hereunder. 3) Any Insured Event hereunder must be related to or arise from an Insured Member s duties as an Ohio State Trooper. 4) Coverage hereunder for any Insured Event Instituted during a Policy Period is subject to the condition that on the initial effective date of this Master Policy, or on the most recent effective date of coverage for the Named Insured, whichever is later, the Insured Member has no knowledge of any event or circumstance which it knows or could reasonably believe may result in an Insured Event covered by this insurance. 5) Coverage hereunder is subject to the condition that any Insured Event or fact, event or circumstance giving rise to an Insured Event occurs subsequent to the retroactive date referred to in Item 5 of the Declarations and while the Insured Member is current on payment for this Criminal Defense Insurance. 6) Coverage hereunder is subject to the condition that any Insured Event is instituted while the Insured Member is current on payment for this Criminal Defense Insurance. 7) Cancellation. This policy may be canceled by the Named Insured by a written notice stating when thereafter such cancellation shall be effective. If canceled by the Named Insured, Underwriters shall retain the customary short rate proportion of the earned premium hereon. This policy may be canceled by Underwriters by mailing to the Named Insured, named on the Declarations Page at the address set forth, written notice stating when such cancellation shall be effective. Such P1801OST-0508 Page 1 of 5

2 cancellation shall not be effective less than thirty (30) days after mailing by Underwriters. The foregoing notwithstanding, this policy may be canceled in the manner stated above on no less than ten (10) days notice when the cancellation is being effected by reason of the Named Insured s non-payment of premium. The mailing of notice procedure prescribed shall be sufficient notice and the effective date of cancellation stated in the notice shall become the expiration date of the policy. Delivery of written notice by the Named Insured named in the Declarations Page or by Underwriters shall be equivalent to mailing. If canceled by Underwriters, earned premium shall be computed pro rata. Premium adjustment may be made at the time cancellation is effected or as soon as practicable thereafter. The check of Underwriters or any of its representatives, mailed or delivered, shall be sufficient tender of any refund due to the Named Insured. Upon cancellation, all coverage for Insured Members shall cease. III. DEFINITIONS 1. ATTORNEY Attorney shall mean an individual or group duly licensed to practice law at the time and place the legal services are rendered. 2. COINSURANCE The Coinsurance percentage of 35% represents the share of all Insured Event payments to be borne by the Insured Member, uninsured, after application of the deductible. 3. CRIMINAL INVESTIGATION Criminal Investigation means written notification that an Insured Member is called before a grand jury or is the target of a governmental investigation of violation of criminal laws. 4. DEDUCTIBLE Deductible shall mean the amount the Insured Member bears, uninsured, prior to Underwriters obligation to reimburse the Insured Member. 5. DUTY-RELATED INCIDENT Duty-related incident means an actual or alleged act or omission of the participant while acting within the scope of his or her authority as a law enforcement officer for which criminal charges are brought against the participant, and first reported to the Claims Administrator while the participant is an INSURED MEMBER. 6. INSTITUTED OR INSTITUTION The term Instituted or Institution shall mean the time formal written notice of a Criminal Investigation or criminal prosecution is received by an Insured Member. 7. INSURED EVENT Insured Event shall mean the Institution of any Criminal Investigation or criminal prosecution against an Insured Member related to or arising from a Duty Related Incident. 8. INSURED MEMBER P1801OST-0508 Page 2 of 5

3 Insured Member shall mean a person who is a current employee of the State of Ohio in good standing with the Ohio State Troopers Association and who is current on payment of the required premium for this insurance. 9. LEGAL EXPENSE Legal Expense shall mean an Attorney's fee for legal services rendered and associated Expenses incurred by the Insured Member in defense of an Insured Event and subject to the Maximum Legal Expense reimbursable. The term Legal Expense shall not include any judgments, settlements, fines or penalties or expenses other than for legal services by the Insured Member s Attorney. 10. MAXIMUM LEGAL EXPENSE Maximum Legal Expense shall mean the maximum total dollar amount of covered Legal Expense that will be reimbursed to any one Insured Member in respect of all Insured Events Instituted during the Policy Period. 11. NAMED INSURED Named Insured shall mean the Master Policyholder, The Ohio State Troopers Association 12. POLICY PERIOD Policy Period shall mean that period specified in Item 2 of the Declaration Page as the period during which this Master Policy has been issued to the Named Insured. IV. EXCLUSIONS No benefits shall be payable hereunder for Legal Expense: 1) If the Legal Expenses arise out of legal services which are provided, or which could have been provided by an Attorney or group of Attorneys to the Insured Member on behalf of an insurer or another indemnifying organization, which is or may be obligated to reimburse the Insured Member for any or all of its liability in the matter, under the terms of a liability insurance policy or contract or some other type of indemnification agreement or arrangement. However, this exclusion shall not apply to any out-of-pocket Legal Expenses incurred by the Insured Member which are less than or equal to the Insured Member's deductible under such policy or contract or other type of indemnification agreement or arrangement, and which do not exceed the Maximum Legal Expense reimbursable. 2) Incurred in disputes with respect to this insurance including questions as to whether Legal Expenses are payable under this Policy. 3) Arising out of any matter that the Insured Member has conspired with another to Institute or have Instituted. 4) Involving any circumstances or event of which the Insured Member was aware prior to the effective date of the initial Policy Period. 5) Incurred in any matter other than an Insured Event. 6) Arising out of activities of the Insured Member carried on outside the scope of the Insured Member s duties as an Ohio State Trooper. P1801OST-0508 Page 3 of 5

4 7) Arising out of activities of the Insured Member carried on in a private security related business or professional endeavor. 8) Arising out of activities of the Insured Member while acting as an elected or appointed member of any peer review process or similarly constituted body. 9) Incurred in any matter in which the party or parties bringing the matter are members of or alleged members of a class or alleged class, which is intended to be a protected class or alleged protected class, for purposes of the matter being brought. 10) No benefits shall be payable hereunder for loss, settlement or any amounts other than Legal Expense. V. REIMBURSEMENT The Insured Member will be reimbursed solely for Legal Expense incurred in respect of legal services actually rendered, and expenses actually incurred, up to the Maximum Legal Expense for the appropriate Policy Periods, for covered Legal Expense incurred. VI. RECOVERY AND SUBROGATION Underwriters shall be entitled to recover from the Insured Member any and all benefits paid by Underwriters to the Insured Member under this insurance which the Insured Member has otherwise received from any other party in respect of the covered action. If the Underwriters become liable for any payment under this insurance in respect of Covered Expenses, the Underwriters shall be subrogated, to the extent of such payment, to all the rights and remedies of the Insured Member against any party in respect of such Covered Expenses and shall be entitled at their own expense to sue or arbitrate in the name of the Insured Member. The Insured Member shall give to the Underwriters all such assistance in its power as the Underwriters may require to secure their rights and remedies and, at Underwriters' request, shall execute all documents necessary to enable Underwriters effectively to bring suit or demand arbitration in the name of the Insured Member. VII. FREE CHOICE OF ATTORNEYS The Insured Member shall have complete freedom of choice with respect to election of the licensed Attorney who provides legal services in respect of which Legal Expense is reimbursable under this agreement and no Attorney providing legal services in respect of which Legal Expense is reimbursable under this agreement shall be required to act in derogation of his/her professional responsibilities. VIII. WAIVER OF COPAYMENT Upon receiving notice from the Insured Member of an Insured Event, Underwriters will provide a list of panel counsel to the Insured Member. Underwriters will pay 100% of Legal Expenses incurred up to the Maximum Legal Expense reimbursable, less any amount previously reimbursed or reimbursable, if the Insured Member selects an Attorney from the list of panel counsel. If the Insured Member selects an Attorney who does not appear on the list of panel counsel, the 35% Coinsurance indicated on the Declarations Page shall apply. Rates for non-panel counsel will be limited to a maximum per hour of $225. IX. ARBITRATION In the event any controversy or claim of any nature arises out of or relates to this agreement involving two or more parties to this agreement, and cannot be settled among the disputing parties, such controversy or P1801OST-0508 Page 4 of 5

5 claim shall be settled by arbitration in accordance with the then current rules of the American Arbitration Association, and judgment upon the award may be entered in any court having jurisdiction thereof. The arbitrator shall have the power to decide any dispute between the parties concerning the application or interpretation of the agreement and said arbitrator shall have no power to change, or add to the provisions of this agreement. Prior to the beginning of arbitration, each disputing party shall pay an equally proportionate share of the estimated cost of arbitration. NAS Insurance Services, Inc. By: 2008 NAS Insurance Services, Inc. P1801OST-0508 Page 5 of 5