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Trust Operational Agreement Form. This is a South Dakota form and can be use in Workers Compensation.
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Tags: Trust Operational Agreement, South Dakota Workers Compensation,
TRUST OPERATIONAL AGREEMENT
That the bank agrees to set up a trust fund if the Division of Labor and
Management so requests in the event the Irrevocable Letter of Credit is presented for
collection to the Bank. When established, the trust fund shall be referred to as “The
______________________________________________ Workers’ Compensation
Liability Trust. The bank recognizes the trust fund will operate in the following manner:
1.
The purpose of the trust fund is to pay the above named self-insured’s
workers’ compensation liabilities under the South Dakota Workers’
Compensation Law. Such obligation will include the payment of temporary,
permanent and medical compensation, death benefits, court costs,
assessment, and any other liability assessments required or imposed on the
employer/self-insurer by the South Dakota Workers’ Compensation Law.
2.
If a trust fund is established, the trust administrator, subject to approval of the
Division of Labor and Management, may contract with an adjusting company
to adjust, investigate and defend claims made against the self-insured and
the bank may pay the adjusting company reasonable compensation for its
services.
3.
The bank shall be entitled to reimbursement for its reasonable expenses
incurred in the administration of the trust fund in accordance with the bank’s
customary fee schedule in administering such trust.
4.
The bank shall apply and distribute the monies in the trust fund upon receipt
of and in accordance with the duly authorized and executed order of the
Director of Division of Labor and Management, South Dakota Department of
Labor, hereinafter called Director.
5.
The trust fund, if established, shall continue until the happening of either of
the following events, at which time the trust fund shall terminate:
a. The trust estate is completely depleted of funds.
b. Upon the duly authorized and executed order of the Director by reason of
the Director’s finding that the trust fund is no longer required for
satisfaction of the employer’s liabilities under the South Dakota Workers’
Compensation Law. In this event, Payment will be made to the employer,
its successor, trustees, receivers, or assigns upon the determination of
Director that the trust fund or a portion thereof is no longer required for
satisfaction of the employer’s workers’ compensation liability under the
South Dakota Workers’ Compensation Law.
6.
The bank, if the trust fund is established, shall keep accurate records and
accounts of the administration of the trust fund and shall annually furnish to
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Director, or at any time Director shall reasonably request, a full and complete
statement of all receipts and disbursements of the trust fund.
7.
That in the event a trust fund is established, the bank and the Division of
Labor and Management can further augment the above guidelines with more
specific guidelines as to the actual operation of the trust.
___________________________________
Name of Bank
___________________________________
Vice President and Trust
___________________________________
Date
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