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Washington State Fraternal Order of Police Labor Coalition
Legal Defense Fund
Section 14. Claims-Made Coverage-Dates-Extended Reporting Period
  1. Except as provided in subsection B of this section, this Plan applies only to claims that are first made to the Participant and reported to the Plan on or after the Participant's coverage inception date and before the Participant's date of termination of the applicable coverage. In addition, the claim must arise out of an occurrence commencing between the Participant's Retroactive Date, if any, or coverage inception date, and the Participant's date of termination of the applicable coverage. For purposes of determining the reapective dates on which a claim is made and reported:
    1. A claim shall be deemed made to the to the Participant when the Participant is first notified by any persin of information suggesting the possibility of a claim;
    2. A claim shall be deemed reported to the Plan when notice of such claim is first received by the Benefit Administrator; and
    3. All claims by a Participant arising out of the same occurrence shall be deemed made and reported on the respective dates the first claim is madeto the Participant and reported to the Plan.
  2. Claims first reported during an Extended Reporting Period shall be covered only as described in this subsection.
    1. An Extended Reporting Period applies only if:
      1. A Participant's coverage is canceled or not renewed other than because a Participant's membership in the FOP is teminated or suspended; or
      2. the Plan renews or replaces the applicable certificate of participation with a new plan that:
        1. Has a retroactive date later than the Participant's Retroactive Date under this Plan; or
        2. does not apply on the claims-made bases
    2. The Extended Reporting Period commences on the date a Participant's applicable coverage teminates and extends;
      1. Five (5) years for any claim arising out of a covered occurrence which took place prior to termination, if one hundred twenty (120) days after the date of termination; or
      2. One hundred twenty (120) days for all other claims.
    3. The Extended Reporting Period applies only to claims for occurrences that commence after the Participant's Retroactive Date, if any, or coverage inception date, and on or before the Participant's applicable date of termination.
    4. If the Extended Reporting Period applies, covered claims which are first reported during the Extended Reporting shall be deemed made on the last day before the applicable date of termination.
    5. The Extended Reporting Period does not reinstate or increase the limits of liabilitu applicable to any claim.
Section 15. Exclusions. The coverages and Benefits provided under the Plan do not apply to
  1. Claims for occurrences involving activities nor in the scope of employnent;
  2. Claims for which benefits are available under worker's compensation, disability benefits, or similar laws or similar process;
  3. Claims for activities while acring as an elected or appointed member of any peer review or similar process;
  4. Claims arising out of the actual or alleged transmission of any communicable disease;
  5. Payment, or loss incurred as a result, of any administrative proceeding or action, judgment, award, settlement, fine or penalty of any kind;
  6. Under Coverage B, any matter for which representation is available under any mptpr vehicle liability insurance policy or other insurance or self-insurance policy or plan;
  7. Law suits which di not arise directly from alleged acts or omissions of the Participant in the scope of emoloyment;
  8. Attempts to obtain, protest, preserve or set aside pension or retirement benefits or benefit determinations, including disability retirement benefits, or decisions relating to any of these, under any federal, state or local government system; and
  9. The cost of bail bonds, appeal bonds or other bonds.
Section 16. Limits of Liability-Deductibles
  1. Plan Attorney. If the Participant uses a Plan Attorney, there is no limit of liability for Legal Services under Coverages A, B. or C (including advice and consultation for grand jury hearings). Reimbursable Costs are covered up to a maximum limit per claim of $2,000 when using a Plan Attorney; provided that, if reasonable and necessary expert witness expense is incurred which causes this limit to be exceeded, such reasonable additional expense will be covered above the limit as approved by the Executive Committee.
  2. Non-Plan Attorney, If the Participant uses a Non-Plan Attorney, the limit of liability for Legal Services under Coverages A, B or C are subject to maximum limits and a deductible per claim as follows;
    Coverage Level Maximum Plan Participation
    Coverage Level "A" After the first $250.00-$9500.00
    Coverage Level "B" After the first $250.00-$9500.00
    Coverage Level "C" After the first $250.00-$9500.00
    Reimbursable Costs are covered up to a maximum limit per claim of $1000 when using a Non-Plan Attorney. The Plan reserves the right to to refuse to make direct benefit payments to a Non-Plan Attorney who has, in dealings with the Plan, refused or neglected to provide reports and billings in accordance with Plan requirements and/or has tendered bills for hours of representation in excess of the usual and customary amount for similar representation in the geographic area of representation. If the Plan refuses ti make direct payment, the Plan shall reimburse the Participant in the usual and customary amount applicable to the representation. Such payment shall relieve the Plan of any obligation to the Non-Plan Attorney and the Participant for that representation,
  3. Deductibles. The Plan's obligation to pay applies only to the amount of Legal Defende Costs in excess of any applicable deductubles, as stated in the certificate if participation. Deductibles apply to aol Legal Defense Costs sustained as the result of any one claim.

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