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LMC <br />LEAGUE ffi <br />MINNESOTA <br />CITIES <br />LIABILITY COVERAGE WAIVER FORM <br />Members who obtain liability coverage through the League of Minnesota Cities Insurance Trust <br />(LMCIT) must complete and return this form to LMCIT before their effective date of coverage. <br />Email completed form to your city's underwriter, to pstech(iHmc.org, or fax to 651.281.1298. <br />The decision to waive or not waive the statutory tort limits must be made annually by the <br />member's governing body, in consultation with its attorney if necessary. <br />Members who obtain liability coverage from LMCIT must decide whether to waive the statutory <br />tort liability limits to the extent of the coverage purchased. The decision has the following effects: <br />• If the member does not waive the statutory tort limits, an individual claimant could recover no more <br />than $500,000 on any claim to which the statutory tort limits apply. The total all claimants could <br />recover for a single occurrence to which the statutory tort limits apply would be limited to <br />$1,500,000. These statutory tort limits would apply regardless of whether the member purchases the <br />optional LMCIT excess liability coverage. <br />If the member waives the statutory tort limits and does not purchase excess liability coverage, a <br />single claimant could recover up to $2,000,000 for a single occurrence (under the waive option, the <br />tort cap liability limits are only waived to the extent of the member's liability coverage limits, and <br />the LMCIT per occurrence limit is $2,000,000). The total all claimants could recover for a single <br />occurrence to which the statutory tort limits apply would also be limited to $2,000,000, regardless <br />of the number of claimants. <br />• If the member waives the statutory tort limits and purchases excess liability coverage, a single <br />claimant could potentially recover an amount up to the limit of the coverage purchased. The total all <br />claimants could recover for a single occurrence to which the statutory tort limits apply would also <br />be limited to the amount of coverage purchased, regardless of the number of claimants. <br />Claims to which the statutory municipal tort limits do not apply are not affected by this decision. <br />LMCIT Member Name: <br />Check one: <br />❑The member DOES NOT WAIVE the monetary limits on municipal tort liability established by <br />Minn. Stat. § 466.04. <br />❑The member WAIVES the monetary limits on municipal tort liability established by Minn. Stat. § <br />466.04, to the extent of the limits of the liability coverage obtained from LMCIT. <br />Date of member's governing body meeting: <br />Signature: <br />Position: <br />League of Minnesota Cities <br />Liability Coverage Waiver Form <br />55 <br />3/2/2023 <br />Page 1 <br />