California Code of Regulations › Title 10 - Investment › Chapter 5 - Insurance Commissioner › Subchapter 2 - Policy Forms and Other Documents › Article 7 - Workers' Compensation Policy Forms › Section 2250 - Definitions

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
The following definitions shall apply to this
					 Article.
(a) "Policy form" means a
				  form that an insurer uses to provide workers' compensation insurance coverage
				  to an employer after the form is approved by the Insurance
				  Commissioner.
(b) "Endorsement" or
				  "endorsement form" means a form, agreement or document that amends, adds to,
				  subtracts from, supplements, or revises a policy form and is attached to a
				  policy form to be effective.
(c)
				  "Attached" means that a writing is part of the policy of insurance by (1) being
				  physically connected to the policy or (2) including a statement in the writing
				  that it is incorporated by reference into the policy.
(d) "Attachment clause" means a provision in
				  an endorsement or ancillary agreement identifying the policy of insurance and
				  incorporating the endorsement or ancillary agreement by providing blank spaces
				  for the insertion of a policy number, endorsement or ancillary agreement
				  number, endorsement or ancillary agreement effective date, name of
				  policyholder, and if applicable, a countersignature.
(e) "Limiting and restricting endorsement"
				  means an endorsement that excludes from coverage some portion of workers'
				  compensation liability for which the employer is required to secure payment
				  pursuant to the Labor Code that, after approval of the endorsement by the
				  Insurance Commissioner, may be endorsed to a workers' compensation
				  policy.
(f) "Ancillary agreement"
				  means an agreement that is a supplementary writing or contract relating to a
				  policy or endorsement form that adds to, subtracts from, or revises the
				  obligations of either the insured or the insurer regarding any terms of an
				  insurance policy including, but not limited to, dispute resolution agreements,
				  policy premium amounts or rates, expense or tax reimbursement or allocation,
				  deductible amounts, policy duration, cancellation, or claims administration.
				  "Ancillary agreements" do not include:
(1)
				  Limiting and restricting endorsements as defined in Subdivision (e) of this
				  regulation;
(2) Customized limiting
				  and restricting endorsements as defined in Subdivision (g) of this regulation;
				  or
(3) Agreements specifying only
				  terms described in subdivisions (f)(3)(A) through (f)(3)(F) below, but only if,
				  such terms are disclosed and negotiated contemporaneously with the inception or
				  renewal of the underlying policy, and any revisions or additions to such terms
				  subsequent to the inception or renewal of the policy are mutually agreed upon
				  by the parties:
(A) the method for making
				  payments,
(B) the method for
				  funding deductible amounts or other policy-related charges due under a
				  policy,
(C) the amounts of
				  collateral or security the insured is required to maintain for claims that do
				  not exceed the deductible,
(D)
				  payment due dates,
(E) payment
				  transmittal information, or
(F) the
				  method of selecting a claims administrator, provided that such claims
				  administrator may only administer claims that do not exceed the
				  deductible.