Form WC 00 03 13 (Ed. 4-84), Waiver Of Our Right To Recover From Others Endorsement

Exactly what this source supports

These are the only claims this record is used to carry anywhere in the library.

• The form is designated WC 00 03 13 (Ed. 4-84), attaches to a Workers Compensation and Employers Liability Insurance Policy, and carries the footer '1983 National Council on Compensation Insurance.'

  claim wcrb-wc-00-03-13#c1

• The form reads: 'We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.)'

  claim wcrb-wc-00-03-13#c2

• The form also states: 'This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule.'

  claim wcrb-wc-00-03-13#c3

• The form contains a Schedule in which the person or organization is named.

  claim wcrb-wc-00-03-13#c4

Each claim above has its own address. Link to a single claim with/sources/wcrb-wc-00-03-13#c1, and read the same list with its identifiers, checksums and dates at wcrb-wc-00-03-13.json. A checksum lets you tell whether a claim you cited still says what it said.

Pages that cite this source

Reviewer notes

Downloaded 2026-08-31; the URL returns a one-page PDF, converted with pdftotext -layout and read in full. This is a clean, unaltered copy of the national workers compensation waiver endorsement, used in place of a municipal sample packet copy for better provenance on this form's text. The Wisconsin Compensation Rating Bureau is the posting organization, not the form's filer.