What it does

WC 00 03 11 A (Ed. 8-91) adds Voluntary Compensation Insurance for the group of employees described in its Schedule. If one of them is injured in work necessary or incidental to a scheduled state, the insurer pays an amount equal to the benefits the designated compensation law would require if the employer and employees were subject to it. Part Two employers liability also applies as though the state of employment were in Item 3.A.

Key provisions

  • Territory: U.S., its territories or possessions, or Canada, and elsewhere for U.S. or Canadian citizens temporarily away.
  • Before payment: the injured person must release the employer and insurer, assign recovery rights against others and cooperate. If the person sues the employer or insurer instead, the duty to pay ends.
  • Exclusions: obligations under an actual compensation law, and injury intentionally caused or aggravated by the employer.
  • Recoveries from third parties repay the insurer's expenses and benefits first.

Who needs it

Employers with workers outside the act's mandatory coverage who still want those workers to have a compensation-style benefit: farms with exempt agricultural labor, households, employers below a state's employee-count threshold, or companies that want to offer a designated state's benefits to a group. Vessel crews use the maritime version (WC 00 02 03) instead.

Quoting and selling notes

  • The benefit is voluntary; the employee can still sue. Voluntary compensation works by trading prompt benefits for a release, so employers liability limits remain important.
  • Define the employee group clearly in the Schedule (by job, location or name) and name the designated law.
  • Compare with simply adding the state to Item 3.A. when employees are subject to that state's act; voluntary compensation is not a substitute for statutory coverage.

Related forms

Voluntary compensation maritime WC 00 02 03; exclusions WC 00 03 08 and WC 00 03 15.