The ICRB files all standard forms with the IDOI on behalf of all members for their use.
The Indiana Bureau files all standard forms (policy, endorsement, cancellation) with the Department of Insurance on behalf of the ICRB Members for the member’s use. This is accomplished by filing the NCCI Forms Manual of Workers Compensation and Employers Liability Insurance Manual.
If a carrier wants to use a non-standard form, it must first be sent to the ICRB for review. The ICRB will review and make a decision on whether or not to file this form for approval with the Indiana Department of Insurance. The final decision to approve use of any non-standard form would be made by the Indiana Department of Insurance.
The attached document, New Simplified 1984 WC & EL Insurance Policy file contains an explanation of the numbering scheme for the standard workers compensation policy and endorsements. For instance, the information page is identified as “WC 00 00 01.”
The WC & EL policy went through revisions on 04/01/84 and 04/01/92.
For the 04/01/92 change, NCCI printed a booklet titled “The Guide to Workers Compensation and Employers Liability Policy” that presented the changes in underlined text.