Orange County NC Website
Browse       Search
HEALTHCARE PROVIDERS SERVICE <br /> ORGANIZATION PURCHASING GROUP <br /> �� Certificmtm of 3* muronte min <br /> s <br /> nurses service organization <br /> OCCURRENCE POLICY FORM <br /> PRODUCER BRANCH PREFIX POLICY NUMBER Policy Period: <br /> 018008 970 HPG 0003508284-8 ' FmrnO900/12toO8/O8/13ut12:O1AM Standard Time <br /> Named Insured Program Administered by: <br /> Nurses Service Organization <br /> Linda K Textoris 159 E. County Line Road <br /> 750 Weaver Dairy Rd A 204 Hatboro, PA 19040-1218 <br /> Chapel Hill, NC 27514-1466 1'800-247-1500 <br /> www.nso.com <br /> Medical Specialty Code Insurance is provided by: <br /> Registered Nurse 80864 <br /> American Casualty Company of Reading, Pennsylvania <br /> 333 South Wabash Avenue Chicago, Illinois 60604 <br /> Professional Liability $1,000,000 each claim $6,000,000 aggregate <br /> Your professional liability limit shown above include the following <br /> • Good Samaritan Liability • Malp|aoennentLtabU|ty • Personal Injury Liability <br /> • Sexual Misconduct included in the PL Limit shown above subject to$25,000 aggregate sublimit <br /> Coverage Extensions <br /> License Protection $ 25,000 per proceeding $ 25,000 aggregate <br /> Defendant Expense Benefit $ 1,000 per day limit $ 25,000 aggregate <br /> Deposition Representation $ 10,000 per deposition $ 10,000 aggregate <br /> Assault $ 25,000 per incident $ 25,000 aggregate <br /> Includes Workplace Vio/ence Counseling <br /> Medical Payments $ 25,000 per person $ 100,000 aggregate <br /> First Aid $ 10,000 per incident $ 10,000 aggregate <br /> Damage to Property of Others $ 10,000 per incident $ 10,000 aggregate <br /> Information Privacy(HIPAA) Fines& Penalties $ 25,000 per incident $ 25,000 aggregate <br /> Workplace Liability - <br /> Workplace Liability Included in Professional Liability Limit shown above <br /> Fire and Water Legal Liability Included in the PL limit above subject to$150,000 aggregate sublimit <br /> Personal Liability $1,000,000 aggregate <br /> Total:$106.00 <br /> Premium reflects employed, full-time rate. <br /> Policy Forms & Endorsements (Please see attached st for a general description of many common policy forms arid endorsements.) <br /> G-121500-D G-121581-C G-121503'C 8-145184-4 8-147292-A E;SL3888 GSL3908 G8L13424 <br /> GSL15563 GSL15564 GSL15565 GSL171O1 G-123846-C32 GSL10546NC <br /> vL v ^ <br /> Chairman of the Board Secretary <br /> Keep this Certificate of Insurance in a safe place, This Certificate of Insurance and proof of payment are your proof of coverage. <br /> There is no coverage in force unless the premium is paid in full. In order to activate your nmverogn, please remit premium in full by <br /> the effective date of this Certificate of Insurance. <br /> Form #: G-141241-B (3K2O10) Master Policy: 188711433 <br /> Ka8 mm-402*oUR-N1 20120628-015-003532 °°,, <br />