Coverage description
A National Council on Compensation Insurance (NCCI) standard form. It provides employers liability coverage without workers compensation for work in the states in its schedule, and excludes employee injury claims where the employer loses common law defenses or is penalized for not meeting that state's workers compensation law.
Updated
What the form says
Key clauses from edition C, the latest revision, quoted as filed.
“Part One (Workers Compensation Insurance) does not apply to work in a state shown in the Schedule.”
WC 00 03 03 C
No workers compensation in scheduled states. Statutory benefits for work in a scheduled state are not paid under this policy. The employer has to meet that obligation some other way.
“applies to work in states shown in the Schedule as though they were shown in Item 3.A. of the Information Page”
WC 00 03 03 C
Employers liability still applies there. Part Two answers employee injury suits arising from work in the scheduled states on the same terms as in the Item 3.A states.
“when you are deprived of common law defenses or are subject to penalty because of your failure to secure your obligations”
WC 00 03 03 C
No coverage when the employer is out of compliance. If the employer has not secured workers compensation as a scheduled state requires, and so loses its common law defenses or faces a penalty, claims for those employee injuries are excluded.
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 editionRevision C drops the exclusion for bodily injury to members of an aircraft's flying crew, so employers liability under this endorsement no longer carves out flight crew.
Edition B
“bodily injury to any member of the flying crew of any aircraft”
Edition C
Removed
Editions
Revision letters as filed, newest first. Filing counts include every state submission that lists the edition.
| Edition | Filings | Companies | States | Filed | Document |
|---|---|---|---|---|---|
| CLatest | 167 | 100 | 25 | Jan 2022 to Nov 2026 | View PDF |
What the filings show
- Edition in use: in the past 12 months, 48 companies filed edition C.
- WC 00 00 00 (Workers Compensation and Employers Liability Insurance Policy) is filed alongside it most often, in 150 of the same filings (90%).
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 03 03, out of 36 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 | C | Jun 4, 2026 |
| Nationwide Corporation Group5 group companies filed it, led by Crestbrook Insurance Company and Nationwide Agribusiness Insurance Company | 15 | 4 | C | Jun 30, 2026 |
| United Fire & CAS GroupUnited Fire and Casualty Company | 15 | 12 | C | May 4, 2026 |
| Louisiana Workers Compensation GroupPrescient National Insurance Company | 7 | 4 | C | Jul 10, 2025 |
| Tokio Marine Holdings Incorporated Group5 group companies filed it, led by Safety First Insurance Company and Safety National Casualty Corporation | 7 | 2 | C | Jun 11, 2026 |
| AXA Insurance Group5 group companies filed it, led by Greenwich Insurance Company and XL Insurance America, Inc. | 6 | 2 | C | Jun 23, 2026 |
| Amtrust Financial Services Group9 group companies filed it, led by ARI Insurance Company and AmTrust Insurance Company | 6 | 2 | C | Feb 25, 2026 |
| Arch Insurance Group3 group companies filed it, led by Arch Indemnity Insurance Company and Arch Insurance Company | 6 | 3 | C | Apr 8, 2026 |
| Sompo Group2 group companies filed it, led by Sompo America Fire and Marine Insurance Company and Sompo America Insurance Company | 6 | 2 | C | Jun 15, 2026 |
| American Financial Group8 group companies filed it, led by Great American Alliance Insurance Company and Great American Assurance Company | 5 | 3 | C | Sep 30, 2026 |
How the largest insurers handle WC 00 03 03
Groups among the largest workers compensation insurers that filed WC 00 03 03 or their own version in the past five years.
- Travelers GroupFiles its own version: XC 99 0013 (00) Employers Liability Coverage Endorsement (38 states)
- Amtrust Financial Services GroupUses WC 00 03 03 in 6 filings
States
Number of filings that include WC 00 03 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 00 00Workers Compensation and Employers Liability Insurance Policy150 filings
- WC 00 04 22Terrorism Risk Insurance Program Reauthorization Act Disclosure Endorsement123 filings
- WC 00 03 08Partners, Officers and Others Exclusion Endorsement122 filings
- WC 00 03 11Voluntary Compensation and Employers Liability Coverage Endorsement122 filings
- WC 00 03 05Joint Venture as Insured Endorsement119 filings
- WC 00 03 13Waiver of Our Right to Recover From Others Endorsement119 filings
- WC 00 03 01Alternate Employer Endorsement118 filings
- WC 00 03 02Designated Workplaces Exclusion Endorsement118 filings
- WC 00 04 21Catastrophe (Other Than Certified Acts of Terrorism) Premium Endorsement118 filings
- WC 00 03 10Sole Proprietors, Partners, Officers and Others Coverage Endorsement117 filings
Recent filings
Latest filings that include this form number. Filed copies open in FilingFocus.
| Submitted | Company | State | Editions | Tracking number |
|---|---|---|---|---|
| Nov 2, 2026 | Illinois Casualty Company | OR | C | ILCC-135079829 |
| Sep 30, 2026 | National Interstate Insurance Companyand 3 more | MI | C | NTNL-135108634 |
| Sep 30, 2026 | National Interstate Insurance Companyand 3 more | NJ | C | NTNL-135108694 |
| Sep 16, 2026 | ZNAT Insurance Company | CT | C | ZICO-135090521 |
| Aug 18, 2026 | RLI Insurance Company | CO | C | RLSC-135057018 |
| Aug 7, 2026 | Motorists Commercial Mutual Insurance Company | WY | C | BSIN-135025946 |
| Jun 30, 2026 | American Casualty Company of Reading, Pennsylvaniaand 5 more | CO | C | CNAB-135003197 |
| Jun 30, 2026 | Crestbrook Insurance Companyand 1 more | CO | C | NWPP-135003409 |
| Jun 30, 2026 | National Casualty Company | CO | C | NWPP-135004216 |
| Jun 23, 2026 | Allmerica Financial Alliance Insurance Companyand 5 more | CO | C | HNVX-134968029 |
| Jun 23, 2026 | AXA XL Insurance Company Americasand 3 more | CO | C | XLAM-134996276 |
| Jun 15, 2026 | Sompo America Fire and Marine Insurance Companyand 1 more | CO | C | SMPJ-134970923 |
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 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