Coverage description
A National Council on Compensation Insurance (NCCI) standard form. The standard workers compensation and employers liability policy. Part One pays the benefits state law requires in Item 3.A states, Part Two covers employer liability suits up to the Item 3.B limits, and Part Three extends coverage to Item 3.C states.
Updated
What the form says
Key clauses from edition C, the latest revision, quoted as filed.
“We will pay promptly when due the benefits required of you by the workers compensation law”
WC 00 00 00 C
What Part One pays. Part One has no dollar limit. It pays whatever benefits the workers compensation law of each Item 3.A state requires of the employer.
“regardless of the number of employees who sustain bodily injury by disease”
WC 00 00 00 C
How the employers liability disease limit works. The disease policy limit is a total for all disease claims under Part Two. A separate each employee limit caps any one person's disease claim, and accident claims have their own each accident limit.
“coverage will not be afforded for that state unless we are notified within thirty days”
WC 00 00 00 C
When work in an unlisted state is covered. Work already under way on the effective date in a state missing from Item 3.A is covered only if the insurer is told within 30 days. Work that starts later in an Item 3.C state is treated as if that state were listed in Item 3.A.
“punitive damages related to your duty or obligation to provide transportation, wages, maintenance, and cure”
WC 00 00 00 C · New in this edition
Maritime punitive damages are excluded. Employers liability already excluded injury to a vessel's master or crew. Revision C adds that it does not pay punitive damages tied to the employer's maritime duty of transportation, wages, maintenance and cure.
How the form has changed
1 change across 1 revision, newest first. Each edition is compared with the one before it, using wording from filed copies.
Edition C
Compared with edition BLatest editionThe vessel crew exclusion in Part Two now also bars punitive damages tied to the employer's maritime duty to provide transportation, wages, maintenance and cure. Revision B excluded crew injury without that sentence.
Edition B
Not in this edition
Edition C
“punitive damages related to your duty or obligation to provide transportation, wages, maintenance, and cure”
Revision C also rewrites the federal statute citations in the employers liability exclusions, including the renamed Federal Mine Safety and Health Act, without changing what those exclusions remove.
Editions
Revision letters as filed, newest first. Filing counts include every state submission that lists the edition.
| Edition | Filings | Companies | States | Filed | Document |
|---|---|---|---|---|---|
| CLatest | 359 | 191 | 46 | Nov 2021 to Nov 2026 | View PDF |
| B | 34 | 12 | 15 | Mar 2022 to Nov 2026 | View PDF |
2 other edition dates appear in one or two filings each, often carrier-specific versions: A, Original.
Where filings record what this form replaced, they name other forms SAME, NA. Only some filings record replacements.
What the filings show
- Edition in use: in the past 12 months, 80 companies filed edition C and 7 companies filed edition B.
- WC 00 00 01 (Information Page) is filed alongside it most often, in 259 of the same filings (66%).
Filed under
Data from admitted P&C filings with state insurance departments, submitted Nov 2021 to Nov 2026, excluding withdrawn and rejected filings. One filing can cover several affiliated companies.
Carriers filing this form
The 10 carrier groups with the most filings that include WC 00 00 00, out of 76 in total.
| Carrier | Filings | States | Editions, most filed first | Last filed |
|---|---|---|---|---|
| WCF Insurance Company GroupWCF Select Insurance Company | 38 | 38 | C | May 8, 2023 |
| Builders Insurance Group5 group companies filed it, led by National Builders Insurance Company and American Builders Insurance Company | 27 | 13 | B | Jun 18, 2026 |
| Nationwide Corporation Group11 group companies filed it, led by Crestbrook Insurance Company and Nationwide Agribusiness Insurance Company | 27 | 5 | C | Jun 30, 2026 |
| Brookfield Wealth Solutions Group5 group companies filed it, led by Argonaut Insurance Company and Argonaut-Midwest Insurance Company | 22 | 3 | C | Aug 11, 2026 |
| Midwest Financial Holdings Group3 group companies filed it, led by Midwest Insurance Company and West River Insurance Company | 21 | 15 | C | Apr 1, 2025 |
| Amtrust Financial Services Group12 group companies filed it, led by Milford Casualty Insurance Company and AmTrust Insurance Company | 18 | 7 | C | Feb 25, 2026 |
| United Fire & CAS Group2 group companies filed it, led by United Fire and Casualty Company and Addison Insurance Company | 16 | 13 | C | May 4, 2026 |
| Liberty Mutual Group10 group companies filed it, led by American Fire and Casualty Company and Ohio Security Insurance Company | 11 | 10 | C | Oct 26, 2022 |
| Tokio Marine Holdings Incorporated Group2 group companies filed it, led by Safety First Insurance Company and Safety National Casualty Corporation | 10 | 5 | C | May 14, 2025 |
| American Financial Group10 group companies filed it, led by Bridgefield Indemnity Insurance Company and Great American Alliance Insurance Company | 9 | 5 | C | Apr 13, 2026 |
How the largest insurers handle WC 00 00 00
Groups among the largest workers compensation insurers that filed WC 00 00 00 or their own version in the past five years.
- Hartford Fire & CAS GroupUses WC 00 00 00 in 1 filing
- Travelers GroupUses WC 00 00 00 in 1 filing
- Amtrust Financial Services GroupUses WC 00 00 00 in 16 filings
- Zurich Insurance GroupFiles its own version: U-WC-417-A CW Workers Compensation and Employers Liability Insurance Policy (1 state)
States
Number of filings that include WC 00 00 00 in each state, Nov 2021 to Nov 2026. Darker states have more filings.
Often filed with
Standard-style form numbers that appear in the same filings most often.
- WC 00 00 01Information Page259 filings
- WC 00 04 22Terrorism Risk Insurance Program Reauthorization Act Disclosure Endorsement168 filings
- WC 00 03 08Partners, Officers and Others Exclusion Endorsement161 filings
- WC 00 04 21Catastrophe (Other Than Certified Acts of Terrorism) Premium Endorsement158 filings
- WC 00 03 13Waiver of Our Right to Recover From Others Endorsement156 filings
- WC 00 03 11Voluntary Compensation and Employers Liability Coverage Endorsement152 filings
- WC 00 04 19Premium Due Date Endorsement151 filings
- WC 00 03 03Employers Liability Coverage Endorsement150 filings
- WC 00 04 03Experience Rating Modification Factor Endorsement150 filings
- WC 00 04 06Premium Discount Endorsement150 filings
Recent filings
Latest filings that include this form number. Filed copies open in FilingFocus.
| Submitted | Company | State | Editions | Tracking number |
|---|---|---|---|---|
| Nov 5, 2026 | Atlantic Charter Insurance Company | PA | CB | CHAR-135152191 |
| Nov 2, 2026 | AmFed Advantage Insurance Companyand 3 more | WA | C | GREY-135137891 |
| Nov 2, 2026 | Illinois Casualty Company | OR | C | ILCC-135079829 |
| Oct 6, 2026 | iQUE Insurance Company | PA | C | BURK-135112958 |
| Sep 8, 2026 | Brotherhood Mutual Insurance Company | ND | C | BRTH-134993127 |
| Aug 18, 2026 | RLI Insurance Company | CO | C | RLSC-135057018 |
| Aug 11, 2026 | American National Property And Casualty Company | PA | C | ANPC-135048226 |
| Aug 7, 2026 | Motorists Commercial Mutual Insurance Company | WY | C | BSIN-135025946 |
| Jul 15, 2026 | Goodville Mutual Casualty Company | SD | C | GDMT-135019111 |
| Jul 14, 2026 | American Sentinel Insurance Company | PA | C | MRTN-134876406 |
| Jul 1, 2026 | Acuity, A Mutual Insurance Company | CO | C | ACUT-134982793 |
| Jun 30, 2026 | American Casualty Company of Reading, Pennsylvaniaand 5 more | CO | C | CNAB-135003197 |
Most filed NCCI WC forms
- WC 00 00 01 Information Page
- WC 00 04 19 Part Five, Premium Amendatory Endorsement
- WC 00 04 21 Catastrophe (Other Than Certified Acts of Terrorism) Premium Endorsement
- WC 00 04 06 Premium Discount Endorsement
- WC 00 03 13 Waiver of Our Right to Recover From Others Endorsement
- WC 00 04 22 Terrorism Risk Insurance Program Reauthorization Act Disclosure Endorsement
- WC 00 03 08 Partners, Officers and Others Exclusion Endorsement
- WC 00 03 03 Employers Liability Coverage Endorsement
- WC 00 03 11 Voluntary Compensation and Employers Liability Coverage Endorsement
- WC 00 04 03 Experience Rating Modification Factor Endorsement
- WC 00 04 04 Pending Rate Change Endorsement
- WC 00 03 01 Alternate Employer Endorsement