04. Liability Coverage Waiver FormLeague of Minnesota Cities 3/2/2023
Liability Coverage Waiver Form Page 1
LIABILITY COVERAGE WAIVER FORM
The decision to waive or not waive the statutory tort limits must be made annually by the
member’s governing body, in consultation with its attorney if necessary.
Members who obtain liability coverage from LMCIT must decide whether to waive the statutory
tort liability limits to the extent of the coverage purchased. The decision has the following effects:
•If the member does not waive the statutory tort limits, an individual claimant could recover no more
than $500,000 on any claim to which the statutory tort limits apply. The total all claimants could
recover for a single occurrence to which the statutory tort limits apply would be limited to
$1,500,000. These statutory tort limits would apply regardless of whether the member purchases the
optional LMCIT excess liability coverage.
•If the member waives the statutory tort limits and does not purchase excess liability coverage, a
single claimant could recover up to $2,000,000 for a single occurrence (under the waive option, the
tort cap liability limits are only waived to the extent of the member’s liability coverage limits, and
the LMCIT per occurrence limit is $2,000,000). The total all claimants could recover for a single
occurrence to which the statutory tort limits apply would also be limited to $2,000,000, regardless
of the number of claimants.
•If the member waives the statutory tort limits and purchases excess liability coverage, a single
claimant could potentially recover an amount up to the limit of the coverage purchased. The total all
claimants could recover for a single occurrence to which the statutory tort limits apply would also
be limited to the amount of coverage purchased, regardless of the number of claimants.
Claims to which the statutory municipal tort limits do not apply are not affected by this decision.
LMCIT Member Name:
Check one:
The member DOES NOT WAIVE the monetary limits on municipal tort liability established by
Minn. Stat. § 466.04.
The member WAIVES the monetary limits on municipal tort liability established by Minn. Stat. §
466.04, to the extent of the limits of the liability coverage obtained from LMCIT.
Date of member’s governing body meeting:
Signature:__________________________ Position:
Members who obtain liability coverage through the League of Minnesota Cities Insurance Trust
(LMCIT) must complete and return this form to LMCIT before their effective date of coverage.
Email completed form to your city’s underwriter, to pstech@lmc.org, or fax to 651.281.1298.
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City of Scandia
Administrator
12/3/25