10.02 Statutory Limit Waiver - Laserfiche WebLink

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o � �� j�EAGUE oF CONNECTING +6�INNOVATING i MINNES�TA SINCE 1913 ! CITIES LIABILITY COVERAGE -WAIVER FORM � LMCIT members purchasing coverage must complete and return this form to LMCIT before the effective date of the coverage.Please retum the completed form to your underwriter or ematl to pstech Imc.org This decision must be made by the member's governing bady every year. You may also wish to discuss these issues with your attorney. League of Minnesota Cities Insurance Trust(LMCIT)member�that obtain liability coverage from LMCIT must decide whether to waive the statutory tort liability limits to the extent of the coverage purchased. The decision has the following effects: � !f the member does not waive the statutary tort limifs,an individual claimant would be able to recover no more than $500,000 on any claim ta which the statutory tort limits apply. The total all claimants would be able ta recover for a single accurrence to which the statutory tort limits apply would be limited to$1,500,000. These statutory tort limits apply regardless of whether the city purchases the op6onal excess liability coverage. � !f the member waives the statutory fort Irmits and does nat purchase excess liability coverage,a single claimant could poten6ally recover up to$2,000,000 for a single occurrence.(Under this option,the tort cap liability limits are waived to the extent of the members liability coverage limits,and the LMCIT per occuRence limit is$2 million.)The total all claimants would be able to recover for a single occurrence to which the statutory tort limits apply would also be limited to$2,000,000, regardless of the number of claimants. � !f fhe member waives the statutory tart timits and purchases excess tiability coverage,a single claimant could potentially recover an amount up to the limit of the coverage purchased. The total all claimants would be able to recaver for a single occurrence to which the statutory tort limits aRply would also be limited to the amount af coverage purchased, regardless of the number of claimants. Claims to which the statutory municipal tort limits do not apply are not affected by this decision. LMCIT Member Name Check ane: [� The member DOES NOT WAIVE the monetary limits on municipal tort liabilityr established by Minnesota Statutes, Section 466.04. ❑ The member WAIVES the monetary limits on municipal tort liability established by Minnesota Statutes,Section 466.04 to the extent of the limits of the liahility coverage obtained from LMCIT. Qate of city counciUgoveming body meeting Signature Position 145 UNIVERSITY AVE.WEST pHotv�(651)281-iZUO �x(651)281-1299 ST.PAUL, MN 55103-2Q44 �ro�.t�(8Q0)925-1122 w�:www.urtcoa�c