Orange County NC Website
Browse       Search
47 <br /> . 1'V I Alabama <br /> Self-Insured <br /> worker's compensation fund <br /> Name: To Whom It May Concern <br /> From: Alabama Self Insured Worker's Comp Fund <br /> P. 0. Box 59509, Birmingham, AL 35259 <br /> Phone: 1-888-515-1530 or 205-868-6900 <br /> Fax: 205-868-6909 <br /> Email Address: ChristinaT@ASIWCF.org <br /> Visit our Website at www.ASIWCF.org <br /> Subject: Waiver of Subrogation <br /> As a Self-Insured Workers' Compensation Fund in Alabama we are not able to issue a Workers' <br /> Compensation policy and thus are not able to offer any of the Workers' Compensation <br /> endorsements. Below is the wording for Waivers of Subrogation requests, approved by our <br /> attorney, which can be added to a Certificate of Insurance issued by your office. <br /> The Alabama Self-Insured Worker's Compensation Fund waives the right to bring an action <br /> against Certificate Holder to enforce any right of subrogation, which may arise from Alabama <br /> Self-Insured Worker's Compensation Fund's payment of workers compensation benefits. This <br /> waiver does not affect (1) the right of an employee of Member to bring an action for damages, <br /> or (2) Alabama Self-Insured Worker's Compensation Fund's right to intervene in such action to <br /> protect any interest in any proceeds of any such action. This waiver shall apply only if and to <br /> the extent required by Certificate Holder. <br /> Please let us know if you have any questions. <br /> Thank you, <br /> Underwriting <br /> Alabama Self-Insured Worker's Compensation Fund <br />