Navigating USL&H Workers Compensation. ZProgramsMatch Webinar Series

Transcription

1 Navigating USL&H Workers Compensation ZProgramsMatch Webinar Series November 16, 2009

2 Agenda Introduction USL&H Workers Compensation Industry Specialists An in-depth look at USL&H Workers Compensation - State Act - USL&H - Admiralty The Zurich Advantage ZProgramsMatch.com Questions and Answers Contacts and Resources 2

3 USL&H Workers Compensation Specialist Ian Greenway Program Administrator for Zurich programs Born and educated in England Attended London University and studied in the United States at the New York College of Insurance One of the founders of the International Institute of Marine Insurance studies and creator of the Certified Marine Insurance Professional designation National Faculty Instructor for the Society of Certified Insurance Counselors and many other professional organizations A nationally recognized authority on Longshore insurance; holds insurance licenses in both England and America and has worked in Lloyd s marketplace for over 30 years Actively involved with the Coalition for Longshore Reform and has testified before congress in support of the Recreational Marine Employment Act Has held Certified Insurance Counselor since 1993; holds the additional designations of Certified Workers Comp Advisor, Insurance Training Professional and Certified Marine Insurance Professional Author of The Association Effect, Navigating Marine Insurance and Navigating Marine Workers Compensation 3

4 USL&H Workers Compensation Specialist Steven Irsay Underwriter Programs & Direct Markets Born and educated in Skokie, IL Responsible for Workers Compensation programs including: - USL&H - Film Production Joined Zurich in July of 2006 as Program Underwriter Formerly a Workers Compensation Underwriter with an MGA. Prior experience includes underwriting and wholesale brokerage of E&O, D&O and malpractice Steve graduated from Drake University with a degree in Insurance where he was an Allstate Scholar 4

5 USL&H Workers Compensation and ZProgramsMatch ZProgramsMatch.com provides a single point of access to Program Administrators (PAs) that write Zurich's USL&H Workers Compensation program. Access is exclusively through our PAs who are knowledgeable in this segment. We do not work directly with retail agents. This program is underwritten by Zurich American Insurance Company, an A.M. Best "A" rated company*. In addition to USL&H, we have other programs in which we work with many highly specialized Program Administrators located throughout the country. * For ratings and financial information about Zurich American Insurance Company, visit 5

6 Federal & International OCSLA FCHSA FELA DBA NAFIA International Longshore & Harbor Workers Compensation Act Protection & Indemnity & Maritime Employers Liability State Workers Compensation

7 Increased Rewards State WC $10,000 Longshore $25,000 Admiralty $50,000 7

8 NCCI State Act Exclusions Workers Compensation Law means the workers or workmen's compensation law and occupational disease law of each state or territory named in Item 3. A. of the information page. It includes any amendments to that law which are in effect during the policy period. It does not include any federal workers or workmen's compensation law, any federal occupational disease law or the provisions of any law that provide non-occupational disability benefits. 8

9 Longshore and Harbor Workers Compensation Act STATUS SITUS + = ELIGIBILITY 9

10 Longshore Act Status The term "employee" means: Any person engaged in maritime employment, including any longshoreman or other person engaged in longshoring operations, and any harbor-worker including a ship repairman, shipbuilder, and ship-breaker, but such term does not include.. 10

11 Longshore Act Status Exclusions A) individuals employed exclusively to perform office clerical, secretarial, security, or data processing work; B) individuals employed by a club, camp, recreational operation, restaurant, museum, or retail outlet; C) individuals employed by a marina and who are not engaged in construction, replacement, or expansion of such marina, except for routine maintenance 11

12 Longshore Act Status Exclusions D) individuals who I. are employed by suppliers, transporters, or vendors, II. are temporarily doing business on the premises of an employer described in paragraph (4) and III. are not engaged in work normally performed by employees of that employer under this Act; E) aquaculture workers; F) individuals employed to build, repair, or dismantle any recreational vessel under sixty-five feet in length; or individuals employed to repair any recreational vessel, or to dismantle any part of a recreational vessel in connection with the repair of such vessel; Individuals described in clauses (A) through (F) are subject to coverage under a State workers compensation law 12

13 Longshore Act Status Exclusions Type of Vessel Repair/Service Build/Construct /Manufacture Recreational <65ft State WC State WC Recreational >65ft State WC Longshore Commercial Longshore Longshore 13

14 Longshore Act Status Exclusions G) a master or member of a crew of any vessel; or H) any person engaged by a master to load or unload or repair any small vessel under eighteen tons net; 14

15 Cases Satisfying the Status Test AMPHIBIOUS WORKER BOOK CLERK CHECKER CHIPPER CLERK CONCRETE FINISHER CONTAINER STUFFER DECK ENGINEER DELIVERY CLERK DIVER DRAFTSMAN BARGE WORKER BURNER (Shipbreaker) CHIP- PILE OPERATOR CLEAN-UP CREW MEMBER COMPUTER TRAINER CONTAINER STRIPPER DARK ROOM ASSISTANT DECKHAND DISPATCHER DOCKBUILDER DREDGEMAN... 15

16 Longshore and Harbor Workers Compensation Act STATUS SITUS + = ELIGIBILITY 16

17 Longshore Act Situs SEC. 3. (a) Except as otherwise provided in this section, compensation shall be payable under this Act in respect of disability or death of an employee, but only if the disability or death results from an injury occurring upon the navigable waters of the United States 17

18 Longshore Act Situs Navigable waters of the United States Ian s Definition A waterway on which you can directly or indirectly travel to another state, country, Gulf of Mexico or Ocean Even if not currently navigable US Navigable Waters = 12 nautical mile limit Waterway use not limited to commercial but includes recreational activities 18

19 Longshore Act Situs Not navigable waters of the U.S. Land Locked Lake Upstream of a Dam on a river, with no locks to bypass Within a single state Coast Guard NOT determinative 19

20 Longshore Act Situs SEC. 3. (a) Except as otherwise provided in this section, compensation shall be payable under this Act in respect of disability or death of an employee, but only if the disability or death results from an injury occurring upon the navigable waters of the United States including any adjoining pier, wharf, dry dock, terminal, building way, marine railway or other adjoining area customarily used by an employer in loading, unloading, repairing, dismantling, or building a vessel 20

21 Longshore Situs Adjoining Area Northwest Marine v Caputo Stripping a container away from vessel a container is the modern equivalent of a ships hold Brady Hamilton v Herron - New test Suitability of site for Maritime Uses Proximity of the waterway Adjoining premises used in Maritime Commerce As close to water as feasible 21

22 Longshore Situs Adjoining Area Gilliam v. Bath Iron Works 20 BRBS 759 (1988) Steel fabricating plant located 3½ to 4½ miles from a shipyard Situated on navigable waters Was determined to be a covered situs Provided fabricated metal parts essential to the purpose of the shipyard The ALJ reasoned that there was an inseparable functional interrelationship between the two facilities in that neither facility can operate independently without the other. These two facilities were considered by the court to constitute a single shipbuilding unit and thereby met the situs requirement of the LHWCA. 22

23 Longshore Act Liability for Compensation Section 4(a) Every employer shall be liable for the payment of compensation If employer is a subcontractor if they fail to secure the payment of compensation the contractor may be liable for compensation. 23

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25 Longshore & Harborworkers Compensation Act Coverage Endorsement WC A This endorsement applies only to work subject to the Longshore and Harbor Workers Compensation Act in a state shown in the schedule. The policy applies to that work as though that state were listed in Item 3.A. of the Information page. 25

26 Longshore Act Penalties for Not Carrying Coverage Fine of not more than $10,000, or by imprisonment for not more than one year, or by both Where employer is a corporation, the president, secretary, and treasurer - severally liable for such fine or imprisonment - severally personally liable for compensation 26

27 Admiralty Exposures 27

28 Admiralty Status Since the establishment of the Merchant Marine Act of 1920 the issue of who is a seaman has caused enormous confusion. Recognizing the diversity of Circuit and Supreme Court decisions on this issue, the Supreme Court selected the Wilander case in 1991 to make some sense of the confusion left in our wake. As a result of the Wilander decision the test for admiralty status is composed of two parts: 1. The worker must have an employment related connection to a vessel in navigation, and 2. Must contribute to the function of the vessel or to the accomplishment of its mission NO EMPLOYMENT RELATIONSHIP TO OWNER REQUIRED FOR STATUS 28

29 General Maritime Law Maintenance & Cure Unseaworthiness Wrongful Death Jones Act Death on the High Seas Act 29

30 Damages Recoverable Under Unseaworthiness and Jones Act Loss of past wages Loss of earning capacity Past and future medical expenses Pain, suffering, and loss of life's enjoyments Pre-Judgment Interest - Only for Unseaworthiness Wrongful death 30

31 Admiralty Exposures Methods of Insuring Maritime Employers Liability Maritime Employers Liability Monoline Protection and Indemnity 31

32 Maritime Employers Liability NCCI Programs Have Limitations Liability limits from a minimum of $25,000 Most assigned risk/state fund carriers can provide maritime employers liability but only for a limit of $25,000 Excess limits are not available through the funds but available through specialty markets NCCI endorsements cover only those injuries that occur in the territorial limits of the continental United States, Alaska, Hawaii or Canada and those operations involving a vessel sailing directly between ports within these territories Excludes coverage provided by a Protection and Indemnity (P & I) policy 32

33 Protection and Indemnity Crew coverage (exclusion) In consideration of the premium (not) charged, it is agreed that the coverage provided by the Protection & Indemnity insurance shall not cover any of the Insured's liability to crew and/or employees of the Insured, or to any employees of contractors or subcontractors 33

34 Federal & International OCSLA FCHSA FELA DBA NAFIA International Longshore & Harbor Workers Compensation Act Protection & Indemnity & Maritime Employers Liability State Workers Compensation

35 The Zurich Advantage Financial strength* Product flexibility Multi-company tier approach Specialized claims handling of USL&H Capacity Geographic coverage scope Access to Zurich risk engineering and industry specialists Access to professional Program Administrators *For ratings and financial information about Zurich American Insurance Company, visit 35

36 ZProgramsMatch.com A quick, online registration is required for access to ZProgramsMatch. If you are not yet registered for access, just go to ZProgramsMatch.com and click on Register.

37 ZProgramsMatch.com Submitting a request to a Zurich Program Administrator or General Agent through ZProgramsMatch.com is easy! Begin at the Home Page Directory and click on the program you are interested in. 37

38 ZProgramsMatch.com You will land on the program page. For more about the program, or to submit a risk, click on Request Contact.

39 Questions 39

40 Contacts and Resources Visit For general inquiries or feedback about the ZProgramsMatch site, contact us at: Please do not utilize this box for business submissions. 40

41 Disclaimers This is intended as a general description of certain types of insurance and services available to qualified customers through the companies of Zurich in North America. The policy is the contract that specifically and fully describes the coverage. The description of the policy provisions gives a broad overview of coverages and does not revise or amend the policy. Insurance coverages underwritten by individual member companies of Zurich in North America, including Zurich American Insurance Company. Certain coverages are not available in all states. Some coverages may be written on a nonadmitted basis through licensed surplus lines brokers. Risk engineering services are provided by Zurich Services Corporation. The information in this presentation was compiled from sources believed to be reliable for informational purposes only. Any and all information contained herein is not intended to constitute legal advice and accordingly, you should consult with your own attorneys when developing programs and policies. We do not guarantee the accuracy of this information or any results and further assume no liability in connection with this presentation, including any information contained herein. 41

42 Thank you for attending! 42