# INCIDENTAL MEDICAL MALPRACTICE AND GOOD SAMARITAN ENDORSEMENT

| Named Insured | Endorsement Number |
|---------------|--------------------|
| Policy Symbol  | Policy Number       | Policy Period | Effective Date of Endorsement |
| Issued By (Name of Insurance Company) |

**THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY**

This endorsement modifies insurance provided under the following:

**COMMERCIAL UMBRELLA LIABILITY POLICY**

Paragraph B.1.a. (4) of Section II. WHO IS AN INSURED, is deleted and replaced by the following:

(4) Arising out of his or her providing or failing to provide professional health care services, except for "bodily injury" arising out of "Incidental Medical Malpractice Injury" by any licensed physician, dentist, nurse or other licensed medical practitioner employed by "you" and acting within the scope of his or her license. The insurance provided hereunder to such persons shall not apply to liability arising out of services performed outside the scope of their duties as your "employees." Any series of continuous, repeated or related acts or omissions by such "employees" will be treated as a single "occurrence."

The following definitions are added to the policy:

"Incidental Medical Malpractice Injury" means "bodily injury" arising out of the rendering of or failure to render the following services:

a. Medical, dental, surgical, x-ray or nursing service treatment or the furnishing of food or beverages in connection therewith, or
b. The furnishing or dispensing of drugs or medical, dental or surgical supplies or appliances, or
c. Those Good Samaritan medical professional services performed by or on behalf of the "insured", without remuneration, in rendering emergency treatment at the scene of an accident or medical crisis, away from the "insured's" facilities

So long as the Named Insured listed in Item 1 of the Declarations is not engaged in the business or occupation of providing any of these services.

All other terms and conditions of the policy remain unchanged.

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**Authorized Agent**

MS-9614 (05/12)