Coverage description
A National Council on Compensation Insurance (NCCI) standard form. It adds voluntary compensation for masters and crew members of scheduled vessels, paying them amounts equal to the benefits a named workers compensation law would provide, if they release you and the insurer and give up their right to sue.
Updated
What the form says
Key clauses from the original edition, which has not been revised, quoted as filed.
“The bodily injury must be sustained by an employee who is a master or member of the crew of a vessel described in the Schedule.”
WC 00 02 03
Who is covered. Coverage is limited to the masters and crews of the vessels listed in the schedule, injured in employment tied to the work described there, within the continental United States, Alaska, Hawaii or Canada or on a voyage directly between their ports.
“We will pay an amount equal to the benefits that would be required of you”
WC 00 02 03
What the insurer pays. The insurer pays crew members what the workers compensation law named in Item 1 of the schedule would require if they were subject to it, to the persons that law would entitle.
“any obligation imposed by a workers compensation or occupational disease law, or any similar law.”
WC 00 02 03
What it does not replace. The payments are voluntary. Any obligation a compensation or occupational disease law actually imposes is excluded here, as is bodily injury you cause or aggravate on purpose.
“If they claim damages from you or from us for the injury or death, our duty to pay ends at once.”
WC 00 02 03
What the crew member gives up. Before payment, the injured person or survivors must release you and the insurer in writing, transfer their recovery rights against others and cooperate. A damages claim against either of you ends the insurer's duty to pay.
How the form has changed
Filed copies carry the original 4-84 edition, with no revision letter.
Editions
Edition dates as filed, newest first. Filing counts include every state submission that lists the edition.
| Edition | Filings | Companies | States | Filed | Document |
|---|---|---|---|---|---|
| OriginalLatest | 99 | 74 | 11 | Jan 2022 to Nov 2026 | View PDF |
What the filings show
- Edition in use: in the past 12 months, 39 companies filed the original edition.
- WC 00 01 04 (Federal Employers' Liability Act Coverage Endorsement) is filed alongside it most often, in 98 of the same filings (99%).
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 02 03, out of 26 in total.
| Carrier | Filings | States | Editions, most filed first | Last filed |
|---|---|---|---|---|
| Brookfield Wealth Solutions Group4 group companies filed it, led by Argonaut Insurance Company and Argonaut-Midwest Insurance Company | 19 | 1 | Original | Jun 4, 2026 |
| AXA Insurance Group5 group companies filed it, led by Greenwich Insurance Company and XL Insurance America, Inc. | 6 | 2 | Original | Jun 23, 2026 |
| Tokio Marine Holdings Incorporated Group2 group companies filed it, led by Safety First Insurance Company and Safety National Casualty Corporation | 6 | 2 | Original | May 14, 2025 |
| Intact Financial Group3 group companies filed it, led by Atlantic Specialty Insurance Company and OBI America Insurance Company | 5 | 1 | Original | Jun 24, 2026 |
| RLI Insurance GroupRLI Insurance Company | 5 | 1 | Original | Aug 18, 2026 |
| Sompo Group2 group companies filed it, led by Sompo America Fire and Marine Insurance Company and Sompo America Insurance Company | 5 | 1 | Original | Jun 15, 2026 |
| State Farm GroupState Farm Fire and Casualty Company | 5 | 1 | Original | May 4, 2026 |
| THE Hanover Insurance Group6 group companies filed it, led by Allmerica Financial Alliance Insurance Company and Allmerica Financial Benefit Insurance Company | 5 | 1 | Original | Jun 23, 2026 |
| Arch Insurance Group2 group companies filed it, led by Arch Indemnity Insurance Company and Arch Insurance Company | 4 | 1 | Original | Apr 8, 2026 |
| Copperpoint Group4 group companies filed it, led by CopperPoint Premier Insurance Company and Alaska National Insurance Company | 4 | 2 | Original | May 27, 2026 |
How the largest insurers handle WC 00 02 03
Groups among the largest workers compensation insurers that filed WC 00 02 03 or their own version in the past five years.
- Amtrust Financial Services GroupUses WC 00 02 03 in 1 filing
States
Number of filings that include WC 00 02 03 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 01 04Federal Employers' Liability Act Coverage Endorsement98 filings
- WC 00 01 08Nonappropriated Fund Instrumentalities Act Coverage Endorsement97 filings
- WC 00 01 06Longshoremen's and Harbor Workers' Compensation Act Coverage Endorsement95 filings
- WC 00 01 01Defense Base Act Coverage Endorsement93 filings
- WC 00 02 01Maritime Coverage Endorsement91 filings
- WC 00 03 04Insurance Company as Insured Endorsement91 filings
- WC 00 03 05Joint Venture as Insured Endorsement91 filings
- WC 00 03 08Partners, Officers and Others Exclusion Endorsement91 filings
- WC 00 03 13Waiver of Our Right to Recover From Others Endorsement91 filings
- WC 00 04 06Premium Discount Endorsement91 filings
Recent filings
Latest filings that include this form number. Filed copies open in FilingFocus.
| Submitted | Company | State | Editions | Tracking number |
|---|---|---|---|---|
| Nov 2, 2026 | AmFed Advantage Insurance Companyand 3 more | WA | Original | GREY-135137891 |
| Oct 2, 2026 | AmFed Advantage Insurance Companyand 3 more | CA | Original | GREY-135104146 |
| Sep 25, 2026 | AmFed Advantage Insurance Companyand 3 more | MI | Original | GREY-135103500 |
| Sep 16, 2026 | ZNAT Insurance Company | CT | Original | ZICO-135090521 |
| Aug 18, 2026 | RLI Insurance Company | CO | Original | RLSC-135057018 |
| Jun 30, 2026 | American Casualty Company of Reading, Pennsylvaniaand 5 more | CO | Original | CNAB-135003197 |
| Jun 24, 2026 | Atlantic Specialty Insurance Companyand 2 more | CO | Original | BEAC-134978198 |
| Jun 23, 2026 | Allmerica Financial Alliance Insurance Companyand 5 more | CO | Original | HNVX-134968029 |
| Jun 23, 2026 | AXA XL Insurance Company Americasand 3 more | CO | Original | XLAM-134996276 |
| Jun 15, 2026 | Sompo America Fire and Marine Insurance Companyand 1 more | CO | Original | SMPJ-134970923 |
| Jun 12, 2026 | All America Insurance Companyand 1 more | CO | Original | CEMC-134982050 |
| Jun 4, 2026 | Argonaut-Midwest Insurance Company | CO | Original | ARGN-134974739 |
Most filed NCCI WC forms
- WC 00 00 01 Information Page
- WC 00 04 19 Part Five, Premium Amendatory Endorsement
- WC 00 00 00 Workers Compensation and Employers Liability Insurance Policy
- 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