Definitions
“CLAIMS ADMINISTRATOR” - means LegalEASE; or its subsidiary.
“COMPLEX WILL” - means the Member has a significant net worth and will benefit from tax planning, or the estate is subject to current state or federal estate taxation; or the Member owns a business that will
continue in operation after death; or the Member wants to put restrictions on what heirs may do with the property; or the Member wants to leave money to someone in a trust because the person cannot manage
his or her own affairs (such as a mentally handicapped child), or wants the property to be managed by a trustee for a period of time past the child’s age of majority, to age 25 or 30, for example; or the Member
thinks that someone will challenge the will; or the Member wants to exclude any lawful dependents.
“COVERED FAMILY MEMBER” – means the Member’s Covered Spouse and the Member’s unmarried dependent children, including stepchildren, legally adopted children, children placed in the home for
adoption and foster children, up to age 19, and from age 19 up to 26 years if they are enrolled in an accredited school or college as full-time student(s), and are primarily dependent upon the Member for support.
“COVERED SPOUSE” - means the Member’s lawful spouse at the time the coverage is in effect.
“DURABLE FINANCIAL POWER OF ATTORNEY” –a legal document that allows an individual to appoint another person to manage the individual’s finances in the event that he/she is unable to do so him/her self.
“EFFECTIVE DATE” - means the date the Member’s coverage hereunder begins.
“HEALTH CARE OR MEDICAL POWER OF ATTORNEY” – A legal document that allows an individual to appoint another person to make medical decisions in the event the individual is unable to do so him/her self.
“LEGAL PLAN ADMINISTRATOR” – LegalEASE, its affiliates, officers, directors, employees, and/or agents, including third party organizations and their affiliates, officers, directors, employees, and/or agents,
hired by LegalEASE to perform services under the Policy.
“LIVING WILL/ HEALTH CARE OR ADVANCE DIRECTIVE” – A legal document that outlines an individual’s preferences for medical treatment and which takes effect only when the individual becomes incapacitated and can no longer express his or her wishes.
“MEMBER” - refers to the individual who (a) is associated with the Policyholder, (b) has either paid a premium or had a premium paid on his or her behalf, and (c) meets the eligibility requirements for Covered Services as defined by the Policyholder.
“MEMBER SERVICE CENTER” - means the service location established to assist Members/Covered Family Members in making full use of the coverage.
“NON-PARTICIPATING ATTORNEY” - means an attorney not contracted by the Legal Plan Administrator who is selected and paid by the Member to provide covered legal services up to the maximum amount
shown under the Non-Participating Attorney column of the Schedule of Benefits.
“PAID IN FULL” - means complete payment in full to a Participating Attorney for covered legal services.
“PARTICIPATING ATTORNEY” - means an attorney contracted by the Legal Plan Administrator to provide covered legal services at the amount shown under the Participating Attorney column of the Schedule of Benefits.
“POLICY” - means the Group Legal Expense Insurance Policy and the Certificate of Coverage.
“POLICYHOLDER” - means the organization named in the declarations page.
“WAITING PERIOD” – means the period after the Effective Date during which certain benefits as shown in the Schedule of Benefits may not be used. This includes any matter that arises prior to the end of the Waiting Period.
“WE”, “US”, “OUR” AND “COMPANY” - means Virginia Surety Company, Inc.
Covered Services
In consideration of payment and receipt by Us of the applicable premium, all Covered Services are available to the Member and all Covered Family Members, except as specifically noted below. The following Covered Services are provided when the Member uses a Participating Attorney. The Schedule of Benefits chart shows the reimbursement schedule when the Member uses a Non-Participating Attorney.
Advice and Consultation
LegalEASE Helpline:
Advice and consultation by telephone with a Participating Attorney. Services are available during normal business hours. Calls can relate to any personal legal matter, civil or criminal, except those specifically excluded.
Initial Law Office Consultation:
Up to the maximum as shown in the Schedule of Benefits for office consultations with an attorney on any personal legal problem, civil or criminal, except those specifically excluded.
Review of Simple Documents:
This benefit includes attorney review, verbal explanations of the meaning or impact of any form or document, or suggestions for changes to a form or proposed document being drafted of up to the maximum number of pages as shown in the Schedule of Benefits. This benefit does not include a
written analysis of any form or document.
Miscellaneous Law Office Services
Discounted Legal Services for any Non-Excluded Legal Matter:
This benefit will cover any legal services to review and/or prepare documents, or any other service required on any legal matters not listed as a Covered Service or Exclusion.
Consumer Matters
Document Preparation:
Preparation of any of the following documents:
• Simple Deed. This benefit is limited to one use per year.
• Promissory Note This benefit is limited to one use per year.
• Consumer Dispute Correspondence This benefit is limited to one use per year.
• Installment Sales Agreement This benefit is limited to one use per year.
• Simple Affidavit. This benefit is limited to one use per year.
• General Power of Attorney This benefit is limited to one use per year per Member/Covered Family Member and can be used for either a General, Limited, or Durable Financial Power of Attorney.
• Lease Agreement (for the Member/Covered Family Member as a tenant only) This benefit is limited to one use per year.
• Time Share Agreement This benefit is limited to one use per year.
Consumer Dispute:
Consultation or representation in a dispute relating to consumer goods and services (not directly or indirectly related to real estate construction or renovation, or landlord/tenant disputes).
This benefit is limited to one use per year.
Small Claims Court Representation:
Consultation and/or representation for a consumer dispute filed in small claims court. (Attorney may not be permitted to attend court hearings in some jurisdictions).
This benefit is limited to one use per year.
Identity Theft Defense:
Services related to the representation of a Member regarding potential creditor actions resulting from identity theft, and attorney services as needed to contact creditors, credit bureaus and financial institutions. It also provides defense services for specific creditor actions over disputed accounts.
This benefit is limited to one use per year.
Estate Planning
Will or Codicil Preparation:
Preparation of one will or codicil (an amendment to an existing will), including the preparation of a simple testamentary support trust for the dependent children:
Will Preparation: Attorney shall prepare a will or codicil and discuss the legal requirements for signing the will. This benefit does not cover Complex Wills, as defined in the Definitions section.
This benefit is limited to one use per year per Member/Covered Family Member.
Living Will/Health Care or Advance Directive/Health Care or Medical Power of Attorney:
This benefit covers the preparation of up to 2 of any of the following documents as defined in the Definitions section per Member/Covered Family Member:
• Living Will
• Health Care Directive
• Advance Directive
• Health Care Power of Attorney
• Medical Power of Attorney
The titles of the above documents may vary by state
This benefit is limited to one document/set of documents per year per Member/Covered Family Member.
Probate of Small Estate:
The service of an attorney for the probate of a small estate (an estate that is not subject to current state or federal estate taxation), up to the maximum as shown in Schedule of Benefits
Residential Matters
Tenant Dispute:
Representation of the Member as a tenant in a dispute with his/her landlord. This benefit does not include representation for a tenant in a dispute with other tenants or for a tenant acting in his/her capacity as sublessee or sublessor.
This benefit is limited to one use per year.
Tenant Security Deposit Dispute:
The services of an attorney to assist the Member as a tenant in recovering a security deposit from the residential landlord for the primary residence; reviewing the lease and other relevant documents; and preparing a demand letter to the landlord for the return of the deposit. This benefit covers preparation for prosecuting a small claims action; helping prepare documents; advising on evidence, documentation and witnesses; and preparing the Member for the small claims trial. The service does not include the attorney’s attendance or representation at the small claims trial, collection activities after a judgment or any services relating to post-judgment actions.
This benefit is limited to one use per year.
Financial Matters
Debt Collection Defense:
The defense of any dispute involving personal (non-business related) debt. This benefit includes correspondence, negotiating with creditors to arrange a repayment schedule, assistance in limiting harassment by bill collectors, and negotiating settlement after a complaint is filed. This service does
not include defense against execution of a court-ordered judgment or efforts to vacate or set aside a judgment.
This benefit is limited to one use per year.
Foreclosure:
Defense of the Member in an action to foreclose on the Member’s primary residence (where Member has resided or intends to reside twenty-seven (27) weeks or more per year.)
This benefit is limited to one use per year.
Tax Audit:
Includes the services of an attorney (but not accounting services) during a personal (non-business related) tax audit required by federal and state tax authorities and negotiations relating to it. This benefit does not include a defense against criminal charges nor the defense of civil tax litigation in any tax court.
This benefit is limited to one use per year.
Family Matters
Prenuptial Agreement:
This service covers the preparation of an agreement by a Member and his or her fiancé/partner prior to their marriage or legal union (where allowed by law), outlining how property is to be divided in the event of separation, divorce or death of a spouse. Representation is provided only to the Member.
The fiancé/partner must have separate counsel or must waive representation.
This benefit is limited to one use per year.
Name Change:
Services required to accomplish a legal name change for a Member/Covered Family Member.
This benefit is limited to one use per year per Member/Covered Family Member.
Guardianship/Conservatorship:
Services required to establish a Member/Covered Family Member as the guardian(s) or conservator(s) of a family member of either the Member or Covered Spouse. This benefit does not include fees for a court-appointed attorney for the child/conservatee.
This benefit is limited to one use per year.
Government Agency/Stepparent Adoption:
Legal representation up to the maximum shown in the Schedule of Benefits in a governmental agency or stepparent adoption. An uncontested adoption does not involve significant disputed issues. This benefit does not include: (1) contested termination of parental rights; (2) fees for a court-appointed
attorney for the child; or (3) adoptions(s) made through any agency other than a governmental agency. A contested adoption requires more than five hours of attorney time and involves disputed issues.
This benefit is limited to one use per year.
Juvenile Court Proceeding:
Services related to the representation of the dependent child of a Member/Covered Family Member in any juvenile court proceeding, provided the child’s interest is not in conflict with the Member’s and/or Covered Family Member’s interest. This benefit does not cover any matter that falls outside
the jurisdiction of juvenile court or any matter that may be considered a felony.
This benefit is limited to one use per year.
Immigration Assistance:
This service covers advice and consultation, preparation of affidavits and powers of attorney, review of any immigration documents, and helping the Member prepare for hearings. This service also covers representation in the defense and/or assertion of status relating to immigration policies. This benefit also extends to the Member’s Covered Family Members and non-covered family members, including the Member’s parent, sibling, grandchild(ren), fiancé(e), and other family members acting as a custodian of the Member’s child(ren) who are attempting to become US citizens in the manner prescribed by law.
This benefit is limited to proceedings involving one covered immigration applicant per year.
Civil Matters
Civil Litigation Defense:
Services related to the representation of a Member who is a named defendant in a filed civil lawsuit (non-business related), up to and including the trial thereof. This benefit does not include: (1) any debt collection or family law matters; (2) lawsuits normally handled on a contingent fee basis; or (3) matters for which the Member has or is required by law to have insurance.
This benefit is limited to one uses per year.
Discounted Contingency Fees:
Participating Attorneys will handle the matter at a maximum percentage of the gross award. It is the Member’s responsibility to pay this fee and all costs.
• When state laws set contingency fees: Lesser of 10% less than state law maximum fee or the Participating Attorney’s usual fee.
• When state laws do not set contingency fee: Maximum of 29% if settled before trial, 36% if trial is conducted, or 40% after an appellate brief is filed.
Contingency rate discount applies in those cases where attorneys customarily take a case on a contingency fee, (an agreed upon portion of any recovery), depending on the outcome of the case.
Mediation:
The services of an attorney for representation at a mediation.
This benefit is limited to one use per year.
Criminal Defense
Traffic Ticket:
Services related to the representation of the Member in defense of any traffic ticket except driving under influence or vehicular homicide, including court hearings, negotiation with the prosecutor, trial, and counseling and preparing Member for self-representation at any hearings if chosen. This benefit does not cover violations related to a commercial driver’s license. This benefit does not apply to Driving Under the Influence (DUI) or Driving While Intoxicated (DWI) violations/citations.
This benefit is limited to one use per year.
Serious Traffic Matter:
Services related to the representation of a Member who is charged by governing authorities with moving traffic violation(s) and conviction could result in suspension or revocation of a state-issued license permitting a person to drive a motor vehicle. This benefit does cover violations related to a commercial driver’s license. This benefit does not apply to Driving Under the Influence (DUI) or Driving While Intoxicated (DWI) violations/citations. This benefit cannot include expungements of misdemeanor convictions.
This benefit is limited to one use per year.
Administrative Proceeding:
Services related to the representation of a Member in an administrative proceeding relating to the suspension or revocation of driving privileges. This benefit does not cover suspension or revocation of a commercial driver’s license.
This benefit is limited to one use per year.
Misdemeanor Defense:
Defense of a Member in connection with criminal misdemeanor charges (not associated with any felony charge).
This benefit is limited to one use per year.
DUI/DWI Defense:
Defense of a Member in connection with Driving Under the Influence (DUI) or Driving While Intoxicated (DWI) violations/citations misdemeanor charges (not associated with any felony charge). This benefit does not include employment related DUI/DWI charges.
This benefit is limited to one use per year.
The following is a list of Covered Services available, in addition to the services described in your Certificate of Coverage.
FINANCIAL ADVISOR
Coverage includes a financial counseling Service for Member, and Covered Family Members.
Financial Helpline
Consultation with legal or financial professionals by toll-free telephone during normal business hours. Calls can relate to investment strategies, debt matters, budgeting or any personal financial planning question.
IDENTITY THEFT PREVENTION/RECOVERY ASSISTANCE
Coverage includes a basic Identity Theft HelpLine Service as well as a comprehensive Online Identity Theft Prevention and
Assistance Service for Member, and Covered Family Members.
Advice and Consultation
Telephone consultations (10 per year) with a Trained Identity Theft Recovery Specialist.
Additional Benefits
a) Personal Recovery Kit – designed to walk a victim of identity theft step-by-step through the process of recovery (designed to be utilized in conjunction with the consultations with the Recovery Specialist).
b) Recovery Letter preparation by plan attorney – a plan attorney will draft the simple affidavits to submit to specific agencies and organizations needed to establish the theft of your identity and prevent further loss of your identity and credit rating.
c) Review of necessary recovery legal documents (up to 6 pages each).
Obtaining Benefits
Claim for Benefits
1. Members should call the Member Service Center to confirm the potentially applicable benefit(s) prior to consulting with any attorney. The Member/Covered Family Member must provide all
information requested with respect to the circumstances of an insured event or service provided. The Member Service Center will assign a Participating Attorney to provide services relative to the
matter. Failure to notify the Member Service Center within thirty (30) days following consultation with an attorney may result in a denial of benefits.
2. To confirm coverage for matters to which Managed Case Rules apply reference Managed Case Rules in the Schedule of Benefits.
3. Members and/or Covered Family Members who are requesting services must remain enrolled and continue to pay premium hereunder.
4. Upon completion of a Covered Service, the Member/Covered Family Member may be required by the Participating Attorney to sign a confirmation of completion. Failure to sign the confirmation
may result in denial of the claim and the Member/Covered Family Member will be responsible for all legal fees.
5. If the Member/Covered Family Member pays for pre-authorized services provided by a Non-Participating Attorney, the Member must submit a reimbursement form (provided by Member
Service Center) accompanied by an original itemized bill, proof of payment and supporting documentation sufficient to demonstrate the work completed in the matter within sixty (60) days
after incurring the legal fees. Benefits provided to the Member/Covered Family Member for Covered Services are subject to the maximum as shown in the Schedule of Benefits.
6. Payment by Us for Covered Services does not preclude the attorney (whether Participating or Non-Participating) from seeking and recovering attorney’s fees from an opposing party, where
authorized by law, court rule, or contract, at the attorney’s customary or prevailing rate. If the Member/Covered Family Member receives reimbursement of attorney’s fees, then the
Member/Covered Family Member agrees to reimburse Us for payments issued.
Disputes Between Member and Covered Family Member
In the event that the Member and one of the Covered Family Members are involved as adversaries in a dispute that is a Covered Service, only the Member will be covered.
If two or more Covered Family Members are involved in a dispute that is otherwise covered, no coverage will be provided.
If two Members are involved as adversaries in a dispute that is a Covered Service, separate coverage for each Member will be provided.
Exclusions
The following benefits are excluded:
Appellate court proceedings, class actions, interventions, malpractice proceedings, actions in which punitive damages are being sought, derivative actions and amicus curiae filings.
The preparation and filing of individual, partnership or estate tax returns, appellate or administrative proceedings related to tax returns, litigation before the U.S. Tax Court, U.S. Court of Claims or any other
federal, state or other courts with respect to tax matters.
Matters relating to: securities, trademark or patent matters; business or commercial interests, including, but not limited to, professional, partnership and/or corporate matters; matters arising out of a
Member/Covered Family Member’s role as an officer or director of an organization; matters involving the law or laws of jurisdictions other than the United States and its territories except as specifically described
under Covered Services; any matters involving a government (domestic or foreign) entity or agency except as specifically described under Covered Services; farm related issues; matters involving commercial or
rental property transactions, including the purchase, sale or lease of investment or income-producing property. A multi-family residence, whether or not used by the Member/Covered Family Member as his or
her primary residence, is deemed an investment or income-producing property. Legal services that are fully paid for or provided at no cost by any governmental agency, organization or
insurance company.
Matters that the attorney deems frivolous, spurious, harassing, or unethical or otherwise prohibited by the Model Rules of Professional Conduct of the state in which the attorney is licensed.
Costs associated with covered legal services, including but not limited to, all fines, court costs, penalties, sanctions, expert witness fees, bonds, bail bonds, attorney fees awarded as part of a judgment, exhibits,
deposition costs, filing fees, transcripts, postage, telephone, photocopying, recording fees, messengers, judgments, jury fees, court reporter fees, investigative costs, mediator or arbitrator fees, and all other
incidental and out-of-pocket legal and litigation costs.
Any services on behalf of a Covered Family Member against the interests of the Member.
Any employment-related matter. This includes, but is not limited to, any dispute involving the Member’s employer or its affiliates, their officers or directors, the Member’s employee benefit plans, credit unions,
programs or arrangements sponsored by an employer, or cases involving workers’ compensation, unemployment compensation, sex harassment, and age discrimination.
Any dispute or proceeding against the following persons or entities, their officers, directors, employees, or agents: any person or entity involved in the sale, marketing, administration or other processes related
to the Policy; Legal Plan Administrator or its subsidiaries; Claims Administrator or its subsidiaries; Policyholder; Member’s employer; Virginia Surety Company, Inc. and it’s parents, subsidiaries or any
affiliated or successor company, plan underwriter or reinsurer; or any Participating and/or Non-Participating Attorney, if the dispute or proceeding pertains to services provided under the Policy.
Except for consultation, the Policy will not provide benefits in connection with pre-existing matters, which includes any matter where the Member/Covered Family Member is on notice as to a pending legal dispute
or has previously contacted an attorney, except when prior coverage under another Legal Plan provided by the Policyholder can be demonstrated.
The Policy does not allow benefits listed under the Covered Services section to be combined for one legal matter.
Where there are specific hours or dollar amounts provided in the Policy, or where a maximum is set under the Managed Case Rules, the Member will be responsible for all attorney fees incurred which exceed the
maximum. Additional exclusions related to each benefit are included in the Covered Services.
General Provisions
Attorney-Client Relationship
All attorneys are subject to the authority of the state Supreme Court and the state bar association of the state(s) where they are licensed to practice. The Member has the unrestricted right to choose an attorney.
The Member’s relationship with an attorney is privileged and strictly confidential. We will not interfere in the attorney-client relationship or in the attorney’s independent exercise of his or her professional
judgment. Participating Attorneys are not certified specialists. Participating Attorneys are not agents or employees of either the Legal Plan Administrator or Us.
The Member shall authorize the Participating Attorney to provide the Legal Plan Administrator with information and supporting documentation on the number and type of services provided to the Member.
By using legal services benefits that are provided under the Policy, the Member agrees that neither We, nor the Policyholder, nor any other person involved in the marketing or administration of the Policy, shall
have any liability for the acts, errors or omissions of an attorney providing services, in whole or in part.
Non-Participating Attorney Services
If the Member already has an attorney, the Member may prefer to use her/him as a Non-Participating Attorney. To do so, the Member must first contact the Member Service Center and notify the
representative of his/her intention to use a Non-Participating Attorney for a Covered Service. The Member Service Center will send the Member a claim form which must be completed and returned in order to
request reimbursement. The Member’s reimbursement will be based on the reimbursement schedule shown under the Non-Participating Attorney column of the Schedule of Benefits. If a Member has a Non-
Participating Attorney he or she would prefer to work with, the Legal Plan Administrator may elect to offer to negotiate with the attorney on behalf of the Member, but cannot guarantee the Non-Participating
Attorney will accept the Plan Discounted Rate.
Subrogation and Coordination of Benefits
All benefits will be subject to subrogation and coordination of benefit rules. For the purpose of subrogation, We may require the Member/Covered Family Member to assign all rights of recovery of legal
fees to the extent that payment is made by Us. If an assignment is sought, the Member/Covered Family Member must cooperate in providing the assignment.
Legal Terminology
The Member or Covered Family Member may call the Member Service Center to obtain a definition or explanation of any term used herein.
Coverage Territory
The coverage territory includes the United States and United States territories.
Premium Refund Provision
In the event that the premium mode is other than monthly and the Group Policy is terminated or the Member elects to terminate the coverage, a pro-rata premium refund will be made in accordance with
the insurance laws of the Policyholder’s state.
Secondary Coverage
If the Member/Covered Family Member is entitled to receive legal services or reimbursement for legal services from any other person or organization, the coverage available under the Policy would be
considered excess as defined in the National Association of Insurance Commissioners Model Coordination of Benefits Provisions.
Termination and Cancellation of Coverage
Coverage provided to the Member shall terminate upon the first of the following to occur:
a. Cancellation or termination of the Group Policy;
b. If applicable, the Member fails to re-enroll;
c. The Member is no longer associated with Policyholder; or
d. The Member fails to remit premium when due, subject to the statutory grace period.
Coverage provided to a Covered Family Member of a Member shall terminate upon the first of the
following to occur:
a. The Member’s coverage is cancelled or terminated; or
b. The family member ceases to qualify as a Covered Family Member as defined in the Definitions
section.
When coverage for a Member/Covered Family Member terminates and a matter is unresolved when
coverage terminated, then any further legal work between said Member/Covered Family Member
and the Participating Attorney shall be outside the scope and coverage of the Policy. The
Participating Attorney shall not be obligated to provide any benefits under the Policy and any further legal services shall be based upon an independent and separate fee agreement entered into, if at
all, between the former Member/Covered Family Member and the attorney. If such an agreement is
not entered into, then the Participating Attorney may withdraw from any further representation in
accordance with applicable law and State Bar standards.
If the Group Policy is cancelled or terminated during the first ninety (90) days for reasons other than
nonpayment of premium, the Company shall provide written notice of cancellation or termination to
the Policyholder at least twenty (20) days prior to the effective date of such cancellation or
termination except where there has been a material misstatement or misrepresentation or failure to
comply with the underwriting requirements established by the Company.
After the Group Policy has been in effect for ninety (90) days, it may be cancelled for the following
reasons:
a. Material misstatement;
b. Nonpayment of premium by Policyholder for covered Members;
c. Failure to comply with underwriting requirements established by the Company within ninety (90)
days of the effective date of coverage; or
d. A substantial change in the risk covered by the Group Policy;
e. Company elects to discontinue underwriting the Group Policy for a given class of insureds.
The Company shall provide written notice of cancellation to the Policyholder at least twenty (20)
days prior to the effective date of such cancellation. If the Company cancels for non-payment of
premium, the Company shall provide written notice of cancellation to the Policyholder at least ten
(10) days prior to the effective date of such cancellation. All notices shall state the reason for
cancellation. The Policyholder is responsible for notifying the Members of cancellation.
The Company shall provide written notice of non-renewal the Policyholder at least forty-five (45)
days prior to the effective date of such non-renewal. All notices shall state the reason for nonrenewal.
Illegal Activity, Misrepresentation and Fraud
We will not provide coverage if the Member/Covered Family Member has intentionally concealed or misrepresented any material fact or circumstances or been involved in any illegal activity related to the
Policy or claim. We will not provide coverage if doing so would be in violation of any United States economic or trade sanction.
Member Complaints
The Member has the right to file a complaint with the Florida Bar concerning attorney conduct pursuant to this plan.
Premium Remittance
The Policyholder shall remit premium to the Company no later than the 10th calendar day following the month for which Group Policy coverage is provided.
Grace Period
The Group Policy provides the Policyholder a grace period of thirty-one (31) days after the premium for covered Members’ due date to remit the premium that is due and unpaid. During the grace period, the Group Policy will continue in effect. If the premium for covered Members remains unpaid at the end of the grace period, the Policy will terminate. Termination will be effective at 12:01 a.m. on the thirty-second (32nd) day following the due date for which premium for covered Members remains unpaid. The Policyholder shall remain liable for the pro-rata portion of all premiums that accrue for the period the Group Policy is in effect.
Amendment of the Policy
The Group Policy may be amended or changed at any time by the Company upon written notice thereof and signed by a duly authorized representative. No agent, broker or sales representative may make any change in the Group Policy or waive any of its provisions. No statement made by any person modifies any term of the Group Policy.
Notice to any agent or knowledge possessed by any agent or by any other person shall not affect a waiver or change any part of the Group Policy or stop Us from asserting any right under the terms of the Group Policy nor shall terms of the Group Policy be waived or changed except as stated above.
Change in Premium
We shall provide the Policyholder written notice of any change in premium forty-five (45) days prior to the anniversary date of the Group Policy. Any such change shall apply to the Policyholder on the anniversary date of the Group Policy. The Policyholder is responsible for notifying the Members of the change in premium.
Portability
The Member may continue this insurance by electing the option of portability when the Member no longer qualifies as an employee of the Policyholder or as a Member of the group to which the Group Policy is
issued. The Member must apply for portability within sixty (60) days of this disqualifying event and make arrangements for premium payment. Portability coverage will take effect, subject to payment of the
initial premium, as of the date the Member’s coverage under the Group Policy terminates. Credit will be given for any applicable Waiting Period based upon the number of months coverage was in force for the
Member under the Group Policy.
Waiver of Premium
Upon the death of the Member, coverage for the surviving Covered Family Members continues for the remainder of the current Group Policy term. We waive further premium payments during this time.
Upon the Member being called to active duty for a period of more than thirty (30) consecutive days for the purposes of military service or of responding to a declared national emergency, coverage for the
Covered Family Members will continue, without the payment of premium, for the length of the Member’s absence and for so long as the Member remains eligible for benefits through the Policyholder.
Conformed to Statute
Any terms herein that conflict with the statutes of the jurisdiction where issued are amended to conform to the statutes.
Assignment of Benefits
The benefits provided herein are not assignable.
Entire Contract
The Group Policy, including the endorsements, if any, constitutes the entire contract of insurance.