Employee Card Misuse Protection



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Transcription:

The following Employee Card Misuse Protection is not available for residents of Puerto Rico and U.S. Virgin Islands. Employee Card Misuse Protection DESCRIPTION OF COVERAGE Underwritten by AMEX Assurance Company Administrative Office, 480 Pilgrim Way, Green Bay, Wisconsin Employee Card Misuse Protection provides insurance which will pay a Basic Cardmember for Unauthorized Expenses charged to the Company s Card Account. Benefit payment under this Plan is contingent upon the Basic Cardmember providing Proof of Loss with respect to the following: 1. the date the Additional Cardmember, who charged the Unauthorized Expense, ceases to be in the employ of the Company; 2. the cancellation of the Additional Cardmember s Card, not more than two business days after the cessation of the Additional Cardmember s employment; and 3. confirmation in writing that the Additional Cardmember will no longer work for the Company in any capacity within six months from the date their employment ceases with the Company. Benefit payment under this Plan is contingent upon the Basic Cardmember providing to Us, upon request, reasonable assistance and cooperation to recover the Unauthorized Expense from the Additional Cardmember. The terms of this Plan do not provide coverage for an Unauthorized Expense by anyone other than an Additional Cardmember. In addition, this Plan does not provide coverage for Additional Cardmembers who are also an Immediate Family Member and/or Company Partner. DEFINITIONS Certain words used in this Description of Coverage are capitalized throughout and have special meanings. Wherever used herein, the singular shall include the plural, the plural shall include the singular, as the context requires. Account means Your American Express Business Card Account. Additional Cardmember means anyone who was issued a Card on behalf of the Company in connection with the Account. Basic Cardmember means the one person who established the Account on behalf of the Company and who maintains a Permanent Residence in the 50 United States of America or the District of Columbia. Card means the American Express Business Card issued to the Basic Cardmember or Additional Cardmember. Company means a business entity or government agency which has established an Account. Company Partner means a person associated with another or others as a principal or a contributor of capital in the Company, usually sharing its risks and profits. Immediate Family Member means a dependent child, by blood or adoption, a parent, a sibling, a spouse or domestic partner of the Basic Cardmember or of a Company Partner. Master Policyholder means American Express Travel Related Services Company, Inc. Permanent Residence means the one primary dwelling place where the Basic Cardmember permanently resides and intends to return. Plan means the Policy and the benefits described therein. Policy means the Group Insurance Master Policy (AX0960 issued to American Express Travel Related Services Company, Inc.).

Unauthorized Expense means any transaction, or series of transactions, including a cash advance, charged to the Company s Account by an Additional Cardmember, which the Company determines it did not authorize the Additional Cardmember to charge, was inappropriate and did not benefit the Company. We, Us, Our means AMEX Assurance Company and its duly authorized agents. You, Your means the Basic Cardmember. DESCRIPTION OF BENEFITS We will make a payment up to a maximum of $100,000 for all Unauthorized Expenses incurred by an Additional Cardmember during the 75 days prior to the Additional Cardmember ceasing to be in the employ of the Company and the permanent and irrevocable cancellation of the Additional Cardmember's Card not more than two business days after the cessation of the Additional Cardmember s employment. EXCLUSIONS The following charges are excluded from coverage under this Plan: 1. interest or fees associated with an Unauthorized Expense, including, but not limited to, ATM fees or currency conversions, charged by American Express; 2. an expense for legal or any other form of expert representation associated with the identification by the Company of an Unauthorized Expense or associated with those elements on which the benefit payment is contingent; or 3. a charge to the Account that is the result of loss or theft of a Card or Card information. For residents of Washington, the first paragraph of this section is removed and replaced with the following: We will not pay for loss caused by any of the excluded charges described below. Loss will be considered to have been caused by an excluded charge if the occurrences of that charge directly and solely results in loss, or initiates a sequence of charges that result in loss, regardless of the nature of any intermediate or final charge in that sequence. CLAIMS PROVISIONS If You have incurred an Unauthorized Expense for which You believe a benefit is payable under this Plan, You must provide Notice of Claim and Proof of Loss to Us. Notice of Claim Notice of Claim should be provided to Us within 30 days of the cancellation of the Additional Cardmember s Card. The Notice of Claim must include the name of the Basic Cardmember and the Additional Cardmember, the American Express Card Account number and a brief description of the Unauthorized Expense. You may contact Us by calling toll-free stateside 800-618-8309. You may also write to Us at AMEX Assurance Company, Attn: Employee Card Misuse Protection, PO BOX 19020, Green Bay, WI 54307-9020. Failure to provide Notice of Claim within 30 days will not invalidate a claim or reduce any benefit payment that may be found to be eligible, if it can be shown that it was provided as soon as reasonably possible and does not prejudice Our right. At the time You provide Us with Notice of Claim, We will assist You with Your Proof of Loss by providing You with instructions and with documents, which You must complete and return to Us. You are required to cooperate with Us and provide documentation as requested by Us which is required and necessary to process Your claim and determine if benefits are payable. Proof of Loss Proof of Loss requires that You send Us all the information We request at Your expense and cooperate with Us in order that We may evaluate the claim and determine whether it qualifies for benefits under the Plan. Proof of Loss should be mailed to Us at the address provided above in the Notice of Claim section as soon as reasonably possible. Our benefit payment under this Plan is contingent upon You providing Proof of Loss which may include any documentation You believe may support Your claim in addition to what We may request, including, but not limited to, the following: 1. completed claim form; 2. all billing statements on which You have identified an Unauthorized Expense in the 75 days prior to the Additional Cardmember s cessation of employment with the Company; 3. explanation which supports Your contention that the Unauthorized Expenses for which You are seeking a payment, were

inappropriate and did not benefit the Company; and 4. copy of the employee/employer agreement or the Company s travel and entertainment guidelines. We reserve the right to request additional information We deem necessary in order to determine whether the claim is payable, and We will not consider that We have received Proof of Loss until We receive the documentation We have requested. If Proof of Loss is not received within 30 days of Notice of Claim (except for documentation which has not been furnished for reasons beyond Your control), coverage may be denied. It is Your responsibility to provide all required documentation necessary. For residents of North Dakota, You must provide Us with satisfactory Proof of Loss within 60 days after We have provided You with instructions and claim forms in response to Your Notice of Claim or Your claim may be denied. Payment of Claim A claim for benefits provided by this Plan will be paid within 30 days of Our receipt and review of Your complete Proof of Loss documentation, and determination that a claim is payable according to the terms, conditions, and exclusions of the Plan. Any payment made by Us in good faith pursuant to this or any other provision of this Plan will fully discharge Us to the extent of such payment. GENERAL PROVISIONS Change of Permanent Residence If the change is to a different state, Your Policy provisions may be adjusted to conform to the requirements of that state. Clerical Error A clerical error made by Us will not invalidate insurance otherwise validly in force nor continue insurance not validly in force. Conformity with State and Federal Law If a Plan provision does not conform to applicable provisions of State or Federal law, the Plan is hereby amended to comply with such law. Entire Contract; Representation Changes The Description of Coverage, the Policy and any applications, endorsements or riders make up the entire contract. Any statement You make is a representation and not a warranty. The Description of Coverage may be changed at any time by written agreement between the Master Policyholder and Us. Only the President, Vice- President or Secretary of AMEX Assurance Company may change or waive the provisions of the Description of Coverage. No agent or other person may change the Description of Coverage or waive any of its terms. The Description of Coverage may be changed at any time by providing notice to You. A copy of the Policy will be maintained and kept by the Master Policyholder and may be examined at any time. Excess Coverage If You have other valid and collectible insurance that covers a loss under this Policy, We will make a payment to You only to the extent Your loss exceeds the amount of Your other insurance, whether that insurance is paid or payable, and subject to the limitations, conditions, provisions and terms of the Policy. Fraud If any request for benefits made under the Plan is determined to be fraudulent, or if any fraudulent means or devices are used by You or by anyone acting on Your behalf to obtain benefits, all benefits will be forfeited. We do not provide coverage to a Cardmember who, whether before or after a loss, has: 1. concealed or misrepresented any fact upon which we rely, if the concealment or misrepresentation is material and is made with the intent to deceive; or 2. concealed or misrepresented any fact if the fact misrepresented contributes to the loss. Legal Actions No legal action may be brought to recover against this Plan until 60 days after Proof of Loss has been received by Us. No such action may be brought after three years for residents of Arkansas five years and residents of Missouri ten years from the time Proof of Loss is required to be given. If a time limit of this Plan is less than allowed by the laws of the state where You live, the limit is extended to meet the minimum time allowed by such law. Right of Recovery If We make a payment to You under this Plan

and You recover an amount from the Additional Cardmember who charged the Unauthorized Expense equal to or less than Our payment, You shall hold in trust for Us the proceeds of the recovery and reimburse Us to the extent of Our payment. If Our payments exceed the maximum amount payable under the benefits of this Plan, We have the right to recover from You any amount exceeding the maximum amount payable. Subrogation In the event of any payment under this Policy, We shall be subrogated to the extent of such payment to all Your rights of recovery. You shall execute all papers required and shall do everything necessary to secure and preserve such rights, including the execution of such documents necessary to enable Us to effectively bring suit or otherwise pursue subrogation rights in Your name. You shall do nothing to prejudice such subrogation rights. We shall be entitled to a recovery as stated in these provisions only after You have been fully compensated for damages by another party. For residents of Louisiana, the Right of Recovery, Subrogation and Excess Coverage sections are revised to reflect: If the Company makes any payment under this Policy and the Cardmember has the right to recover damages from another, the Company shall be subrogated to that right. However, the Company s right to recover is subordinate to the Cardmember s right to be fully compensated. 2. the date We determine that intentional misrepresentation or fraud in the enrollment or claims presentation has occurred by You or someone on Your behalf; 3. the date the Policy is cancelled; 5. the date the Account is terminated by the Basic Cardmember or cancelled by American Express; or 4. the date the Plan is not available in the state where You maintain a Permanent Residence. Termination or Cancellation of coverage will not prejudice any claim originating prior to termination or cancellation, subject to all other terms of the Policy. We have the right to cancel the Policy at any time by sending a written notice at least 60 days in advance to You at Your last known address. The notice will include the reason for cancellation. IMPORTANT ADDITIONAL INFORMATION FOR YOU This Description of Coverage is an important document. Please read it and keep it in a safe place. IN WITNESS WHEREOF, We have caused this Description of Coverage to be signed by Our officers: TERMINATION or CANCELLATION Coverage will cease on the earliest of the following: 1. the date You no longer maintain a Permanent Residence in the 50 United States of America or the District of Columbia; Steve C. Lindstrom President AMEX Assurance Company C. Ray Cliett Secretary AMEX Assurance Company ECMP DOC 04/07

AMEX ASSURANCE COMPANY Administrative Office Phoenix, Arizona ADMINISTRATIVE OFFICE ADDRESS CHANGE ENDORSEMENT Effective May 26, 2009, your certificate or policy is amended to reflect that Amex Assurance Company s Administrative Office is changed to MC: 080120 P.O. Box 53701 20022 N. 31 st Avenue Phoenix, AZ 85072-9872 Phoenix, AZ 85027 All other terms of your certificate or policy remain unchanged. Steve C. Lindstrom President C. Ray Cliett Secretary IMPORTANT: This endorsement becomes a part of your certificate or policy. It should be attached to and kept with your certificate or policy. MG-ADCHG-END1 06/09 AMEX ASSURANCE COMPANY Administrative Office Phoenix, Arizona ADMINISTRATIVE OFFICE ADDRESS CHANGE ENDORSEMENT Effective May 1, 2010, your certificate or policy is amended to reflect that Amex Assurance Company s Administrative Office is changed to MC: 080120 P.O. Box 53701 20022 N. 31 st Avenue Phoenix, AZ 85072-9872 Phoenix, AZ 85027 Effective May 1, 2010, your certificate or policy is amended to reflect that Amex Assurance Company s Claim Administrative Office is changed to P.O. Box 981553 El Paso, TX 79998-9920 All other terms of your certificate or policy remain unchanged. Steve C. Lindstrom President C. Ray Cliett Secretary

IMPORTANT: This endorsement becomes a part of your certificate or policy. It should be attached to and kept with your certificate or policy. MG-ADCHG-END3 04/10 Applicable for Residents of the State of Arizona and Indiana Employee Card Misuse Protection is governed by form number ECMP IND 07/07. References to Description of Coverage and Master Policy throughout the above form have been changed to Policy. The definitions of Master Policyholder and Plan are hereby removed. The following definitions are added to the DEFINITIONS section. American Express Card means any credit or charge card bearing an American Express trademark or logo issued by American Express Travel Related Services Company, Inc. or its subsidiaries or affiliates or any of their licensees which can be used to purchase goods or services at merchants on the American Express Network and which American Express Travel Related Services Company, Inc. designates as eligible for coverage under the Policy. Policy as used throughout means this contract issued to the Policyholder providing the benefits described. Policyholder means the Cardmember. The following provision is revised under the GENERAL PROVISIONS section. Entire Contract; Representation Changes The Policy and any applications, endorsements or riders make up the entire contract. Any statement You make is a representation and not a warranty. Only the President, Vice-President or Secretary of AMEX Assurance Company may change or waive the provisions of the Policy. No agent or other person may change the Policy or waive any of its terms. The Policy may be changed at any time by providing notice to You. The following provision is added to the TERMINATION or CANCELLATION section. Non-Renewal We can non-renew this Policy. All insurance will cease on the date of non-renewal. If We non-renew, We will notify You in writing at least [90 days] prior to the effective date of the non-renewal. In all other respects, the provisions and conditions of the Policy remain the same. Applicable for Residents of the State of Alaska The Legal Actions section is hereby removed in its entirety and replaced with the following which is added and made part of the Description of Coverage: Legal Actions No legal action may be brought to recover against this Plan until (60) days after Proof of Loss has been received by Us. No such action may be brought after three years (for residents of Arkansas five years, residents of Missouri ten years, and residents of South Dakota six years) from the time Proof of Loss is required to be given. If there are any claims the three year timeframe does not begin to run until after the claim has been denied.

If a time limit of this Plan is less than allowed by the laws of the state where You live, the limit is extended to meet the minimum time allowed by such law. ECMP-RDR1-AK 06/07 Applicable for Residents of the State of Colorado AMENDATORY ENDORSEMENT EMPLOYEE CARD MISUSE PROTECTION DESCRIPTION OF COVERAGE/POLICY/CERTIFICATE OF INSURANCE To be attached to and made a part of the Description of Coverage/Policy/Certificate of Insurance. THIS ENDORSEMENT CHANGES YOUR DESCRIPTION OF COVERAGE/POLICY/CERTIFICATE OF INSURANCE. PLEASE READ IT CAREFULLY All definitions, terms and provisions within the Description of Coverage/Policy/Certificate of Insurance wherever appearing and denoting a marital relationship or family relationship arising out of marriage will include parties to a civil union established in the State of Colorado according to Colorado law and their families. The terms that mean or refer to family relationships arising from a marriage, such as family, immediate family, dependent, children, next of kin, relative, beneficiary, survivor and any other such terms include family relationships created by a civil union established according to Colorado law. ALL OTHER TERMS AND CONDITIONS OF THE DESCRIPTION OF COVERAGE/POLICY/CERTIFICATE OF INSURANCE REMAIN UNCHANGED. In Witness Whereof, We have caused this Endorsement to be signed by Our officers. Steve C. Lindstrom President AMEX Assurance Company C. Ray Cliett Secretary AMEX Assurance Company AEREG1013CO Applicable for Residents of the State of Indiana Indiana Residents Only: Questions regarding your policy should be directed to: AMEX Assurance Company 800-618-8309 If you (a) need the assistance of the governmental agency that regulates insurance or (b) have a complaint you have been unable to resolve with your insurer you may contact the Department of Insurance by mail, telephone or email:

State of Indiana Department of insurance Consumer Services Division 311 West Washington Street, Suite 300 Indianapolis, IN 46204-2787. Consumer Hotline: 1-800-622-4461. In the Indianapolis Area 1-317-232-2395. Complaints can be filed electronically at www.in.gov/idoi Applicable for Residents of the State of Missouri The Notice of Claim section is hereby removed in its entirety and replaced with the following which is added and made part of the Description of Coverage: Notice of Claim Notice of Claim should be provided to Us within 30 days of the cancellation of the Additional Cardmember s Card. The Notice of Claim must include the name of the Basic Cardmember and the Additional Cardmember, the American Express Card Account number and a brief description of the Unauthorized Expense. You may contact Us by calling toll-free stateside 800-618-8309. You may also write to Us at AMEX Assurance Company, Attn: Employee Card Misuse Protection, PO BOX 19020, Green Bay, WI 54307-9020. Failure to provide Notice of Claim within 30 days will not invalidate a claim or reduce any benefit payment that may be found to be eligible, if it can be shown that it was provided as soon as reasonably possible and does not prejudice Our right. At the time You provide Us with Notice of Claim, We will assist You with Your Proof of Loss by providing You with instructions and with documents, which You must complete and return to Us. You are required to cooperate with Us and provide documentation as requested by Us which is required and necessary to process Your claim and determine if benefits are payable. For residents of Missouri, no claim will be denied based upon Your failure to provide notice within such specified time, unless this failure operates to prejudice the right of Us. ECMP-RDR1-MO 04/07 Applicable for Residents of the State of New Hampshire The Description of Coverage is subject to laws of the State of New Hampshire. Any contract changes will be submitted for approval in the State of New Hampshire. Contract changes will not be transacted between the Master Policy and the insurer per NH RSA412:5 I. In the Conformity with State and Federal Law section the following is removed: If a Plan provision does not conform to applicable provisions of State or Federal law, the Plan is hereby amended to comply with such law. And replaced with the following: If a Plan provision does not conform to applicable provisions of the State of New Hampshire or Federal law, the Plan is hereby amended to comply with such law. The following is added at the end of the Fraud section of Your Description of Coverage: Concealment, misrepresentation, and fraud can only apply to a claim to which it is material and coverage may not be denied to any Cardmember who had no knowledge of or participation in any concealment, misrepresentation or fraud.

Concealment, misrepresentation, and fraud do not void the Policy and must be an intentional act on behalf of You. We will not deny coverage under the Policy if this occurs. If You are without knowledge or participation in a fraudulent act then You are not subject to denial of coverage under this section. This section only applies to a claim to which it is material and coverage may not be denied to You if You had no knowledge of or participation in any concealment, misrepresentation or fraud. In the TERMINATION OR CANCELLATION section the following is removed: 2. the date We determine that intentional misrepresentation or fraud in the enrollment or claims presentation has occurred by You or someone on Your behalf; And replaced with the following: 2. discovery of fraud or material misrepresentation by the Basic Cardmember in pursuing a claim under the Policy; The Payment of Claim section is hereby removed in its entirety and replaced with the following: Payment of Claim A claim for benefits provided by this Plan will be paid within 5 days of Our receipt and review of Your complete Proof of Loss documentation, and determination that a claim is payable according to the terms, conditions, and exclusions of the Plan. Any payment made by Us in good faith pursuant to this or any other provision of this Plan will fully discharge Us to the extent of such payment. ECMP-RDR1-NH 03/08 Applicable for Residents of the State of New York The DESCRIPTION OF BENEFITS section is hereby removed in its entirety and replaced with the following which is added and made part of the Description of Coverage: DESCRIPTION OF BENEFITS We will make a payment up to a maximum of ($15,000) for all Unauthorized Expenses incurred by an Additional Cardmember during the (75) days prior to the Additional Cardmember ceasing to be in the employ of the Company and the permanent and irrevocable cancellation of the Additional Cardmember's Card not more than (two) business days after the cessation of the Additional Cardmember s employment. ECMP-RDR1-NY 09/07 Applicable for Residents of the State of South Dakota The Legal Actions section is hereby removed in its entirety and replaced with the following which is added and made part of the Description of Coverage: Legal Actions No legal action may be brought to recover against this Plan until (60) days after Proof of Loss has been received by Us. No such action may be brought after three years (for residents of Arkansas five years, residents of Missouri ten years, and residents of South Dakota six years) from the time Proof of Loss is required to be given. If a time limit of this Plan is less than allowed by the laws of the state where You live, the limit is extended to meet the minimum time allowed by such law. ECMP-RDR1-SD 04/07

Applicable for Residents of the State of Texas Employee Card Misuse Protection is governed by form numbers ECMP IND TX 10/07 and ECMP-IND- End1 10/08. References to Description of Coverage and Master Policy throughout the above forms have been changed to Policy. The definitions of Master Policyholder and Plan are hereby removed. The following definitions are added to the DEFINITIONS section. American Express Card means any credit or charge card bearing an American Express trademark or logo issued by American Express Travel Related Services Company, Inc. or its subsidiaries or affiliates or any of their licensees which can be used to purchase goods or services at merchants on the American Express Network and which American Express Travel Related Services Company, Inc. designates as eligible for coverage under the Policy. Policy as used throughout means this contract issued to the Policyholder providing the benefits described. Policyholder means the Cardmember. The following provision is revised under the CLAIMS PROVISIONS section. Payment of Claim Within 15 days after We receive Your Notice of Claim, We must acknowledge receipt of the claim. If Our acknowledgment of the claim is not in writing, We will keep a record of the date, method and content of Our acknowledgement. We must begin any investigation of the claim; and specify the information You must provide in accordance with Your Proof of Loss. After We receive the information We request, We must notify You in writing whether the claim will be paid or has been denied or whether more information is needed within 15 business days. If We do not approve payment of Your claim or require more time for processing Your claim, We must give the reasons for denying Your claim; or give the reasons why We require more time to process Your claim. But, We must either approve or deny Your claim within 45 days after Our request for more time. If We notify You that We will pay Your claim, or part of Your claim, We must pay within 5 business days after We notify You. If payment of Your claim or part of Your claim requires performance of an act by You, We must pay within 5 business days after the date You perform the act. The following provision is revised under the GENERAL PROVISIONS section. Entire Contract; Representation Changes The Policy and any applications, endorsements or riders make up the entire contract. Any statement You make is a representation and not a warranty. Only the President, Vice-President or Secretary of AMEX Assurance Company may change or waive the provisions of the Policy. No agent or other person may change the Policy or waive any of its terms. This Policy may be changed at any time by written agreement between the Policyholder and Us by providing notice to You. The following provision is added to the TERMINATION or CANCELLATION section. We may not cancel or non-renew this Policy based solely on the fact that You are an elected official. Non-Renewal

We can non-renew this Policy. All insurance will cease on the date of non-renewal. If We non-renew, We will notify You in writing at least [90 days] prior to the effective date of the non-renewal. In all other respects, the provisions and conditions of the Policy remain the same. Applicable for Residents of the State of Vermont The TERMINATION or CANCELLATION section is hereby removed in its entirety and replaced with the following which is added and made part of the Description of Coverage: We have the right to cancel the Policy at any time by sending a written notice at least (45) days in advance to You at Your last known address. The notice will include the reason for cancellation. ECMP-RDR1-VT 05/07 Applicable for Residents of the State of West Virginia The Payment of Claim section is hereby removed in its entirety and replaced with the following which is added and made part of the Description of Coverage: Payment of Claim A claim for benefits provided by this Plan will be paid within (15) days of Our receipt and review of Your complete Proof of Loss documentation, and determination that a claim is payable according to the terms, conditions, and exclusions of the Plan. Any payment made by Us in good faith pursuant to this or any other provision of this Plan will fully discharge Us to the extent of such payment. ECMP-RDR1-WV 05/07 Applicable for Residents of the State of Texas

IMPORTANT NOTICE TO OBTAIN INFORMATION OR MAKE A COMPLAINT: You may call AMEX Assurance s toll-free telephone number for information or to make a complaint at: 1-800-618-8309 You may also write to AMEX Assurance Company at: Attn: Employee Card Misuse Protection MC: 080120, 20022 N. 31 st Avenue Phoenix, AZ 85027 You may contact the Texas Department of Insurance to obtain information on companies, coverages, rights or complaints at: 1-800-252-3439 You may write the Texas Department of Insurance at: P.O. Box 149104 Austin, TX 78714-9104 Fax# (512) 475-1771 Web: http://www.tdi.state.tx.us E-mail: ConsumerProtection@tdi.state.tx.us PREMIUM OR CLAIM DISPUTES: Should you have a dispute concerning your claim you should contact the company first. If the dispute is not resolved, you may contact the Texas Department of Insurance. ATTACH THIS NOTICE TO YOUR DESCRIPTION OF COVERAGE: This notice is for information only and does not become a part or condition of the attached document. AVISO IMPORTANTE PARA OBTENER INFORMACION O PARA SOMETER UNA QUEJA: Usted puede llamar al numero de telefono gratis de AMEX Assurance Company s para informacion o para someter una queja al: 1-800-618-8309 Usted tambien puede escribir a AMEX Assurance Company: Attn: Employee Card Misuse Protection MC: 080120, 20022 N. 31 st Avenue Phoenix, AZ 85027 Puede comunicarse con el Departamento de Seguros de Texas para obtener informacion acerca de companies, coberturas, derechos o quejas al: 1-800-252-3439 Puede escribir al Departamento de Seguros de Texas: P.O. Box 149104 Austin, TX 78714-9104 Fax# (512) 475-1771 Web: http://www.tdi.state.tx.us E-mail: ConsumerProtection@tdi.state.tx.us DISPUTAS SOBRE PRIMAS O RECLAMOS: Si tiene una disputa concerniente a un reclamo, debe comunicarse con la compania primero. Si no se resuelve la disputa, puede entonces comunicarse con el departamento (TDI) UNA ESTE AVISO A SU POLIZA: Este aviso es solo para proposito de informacion y no se convierte en parte o condicion del documento adjunto. TX NOTICE