NFI

NFI

Learn How to Enroll in the LegalEASE Plan
X

To enroll in the LegalEASE Plan, please call MMA at 

888-317-3761

Visit the Benefits Enrollment site on My-NFI.com to elect your benefits

For Questions or To Open a Case:
X

We’re here when you need us.

 

Member Services:

To open a case and get matched to an attorney specific to your legal matter, call our member services department at:

   1(888) 416-4313, and reference "NFI",

                    Monday - Friday from 7:00 am to 7:30 PM CST.

 

   Or message us by clicking here.

 

Enrollment Questions:

To learn more about LegalEASE and the legal benefits you will get,

  Call us with any questions about your Legal Insurance Plan!   Call us at: 1(800) 248-9000,

                      reference "NFI"

 

   Or message us by clicking here.

 

 

Welcome

NEW! LegalEASE Attorney Matching Portal

LegalEASE is expanding our online solution options to members. Introducing the newest online self-service portal, LAMP. Now available to access. Learn more 

 

Benefits Proudly Offered to NFI Employees

 

 

Be fully prepared and confident

 with LegalEASE

Learn about legal benefits, a smart option for your protection.

LegalEASE can help ease the two biggest stresses -finding and paying for an attorney.

Nobody likes to be caught off guard, especially when it comes to legal matters. Life can be complicated. Finding a good attorney doesn’t have to be. With LegalEASE, it’s easy to choose the best attorney, because you get assistance from highly trained and qualified personal specialists who review the details of local attorneys and help you find your best source for legal advice. Being a LegalEASE member saves you time and costly legal fees. But most importantly, it gives you confidence and provides coverage for common legal matters.

With a LegalEASE plan, you get:

  • An attorney with expertise specific to your legal matter
  • Access to a national network of attorneys with exceptional experience that are matched to meet your needs
  • Coverage for in and out-of-network
  • Concierge help finding a better attorney and navigating common individual or family legal issues
  • Hours of financial counseling and coaching

We all make some sort of plan in life. But have you ever considered the possibility of a legal problem?

You've graduated from college and are planning for your future - where to get hired, which company will put you on the path to success. Whether to be single or date or settle down, and with the right person. Legal problems can be unexpected and interrupt your plans. LegalEASE provides coverage for your specific legal matter so you won't be caught off guard.

Protect your family’s future, with LegalEASE.

You work hard to make the right choices for your loved ones, especially when it comes to legal and financial matters. Get the peace of mind you want and the protection you need with a LegalEASE Plan. LegalEASE offers valuable benefits to shield your family and savings from unexpected legal issues.                              

According to the American Bar Association, more than 70 percent of U.S. households will have the need for a lawyer in the next 12 months. And the same study found most consumers feel uncertain about how to tell a good lawyer from a bad one. With LegalEASE you have access to a national network of credentialed attorneys and the help you need to find the best attorney for your legal matter with its concierge service.

Coverage

The Value of a LegalEASE Benefits Plan.

Being a LegalEASE benefits plan member saves you time and costly legal fees. But most importantly, it gives you confidence and provides coverage for:
  • Home and Residential
  • Financial and Money Matters
  • Consumer
  • Auto and Driving
  • Family and Personal 
  • Civil Lawsuits
  • Estate planning and wills

LegalEASE Benefits Plan Coverage

Benefits are designed to meet the typical needs of a colleague and their family. There are no deductibles to worry about for covered services. Benefits cover the attorney’s time. Other costs such as filing fees or court costs are not covered. Listed below are the types of matters that are covered by the LegalEASE benefits plan. This plan offers the convenience of in-network and out-of-network benefits. Many of the below areas are fully covered in-network.

Plan Cost

The LegalEASE Plan is $14.75 monthly, via payroll deduction.

Who's Covered? 

The Member’s Covered Spouse and the Member’s unmarried or unpartnered dependent children, including stepchildren, legally adopted children, children placed in the home for adoption and foster children, up to age 26.

Schedule of Benefits

Advice and Consultation

 LegalEASE Plan Coverage

Participating Attorney

 LegalEASE Plan Coverage

Non-Participating Attorney

LegalEASE Helpline

Covered

Not Applicable

Initial Law Office Consultation - one hour(s) per calendar quarter 

Covered

Not Applicable

Review of Simple Documents - Review of documentation up to 6 pages

Covered

Not Applicable

Financial Advisor

 LegalEASE Plan Coverage

Participating Attorney

LegalEASE Plan Coverage

Non-Participating Attorney

Financial Helpline Covered Not Applicable
Identity Theft Prevention/Recovery Assistance

 LegalEASE Plan Coverage

Participating Attorney

LegalEASE Plan Coverage

Non-Participating Attorney

Advice and Consultation Covered Not Applicable
Miscellaneous Services

 LegalEASE Plan Coverage

Participating Attorney

LegalEASE Plan Coverage

Non-Participating Attorney

Legal Services for any non-excluded legal matter not specifically covered in the Schedule of Benefits up to 10 hours per year
Covered
$60/hour
Discounted Legal Services for any non-excluded legal matter 25% Discount on Participating Attorney's Hourly Rates Not Applicable

Consumer Matters

 LegalEASE Plan Coverage

Participating Attorney

 LegalEASE Plan Coverage

Non-Participating Attorney

Document Preparation:

  • Simple Deed
  • Promissory Note
  • Consumer Dispute Correspondence
  • Installment Sales Agreement
  • Simple Affidavit
  • General Power of Attorney:
    • Member & Family Member
  • Lease Agreement - Tenant only
  • Time Share Agreement

Covered

 

  • $65
  • $55
  • $55
  • $55
  • $55
  • $55
  • $65
  • $55

Consumer Dispute

Covered

$595

Small Claims Court Reprsentation

Covered up to 2 hours with remainder at 25% discount

$120

Mail Order or Internet Purchase Dispute Covered $300
Bank Fee Dispute Covered $300 
First-time Vehicle Buyer Covered $300
Vehicle Repair and Lemon Law Litigation Covered $300

Cell Phone Contract Dispute

  • Contract review up to 15 pages
  • Representation
Covered $300
Personal Property Protection Covered $300

Warranty Dispute

  • Warranty review up to 15 pages
  • Representation
Covered $300

Healthcare Coverage Disputes and Records

  • Office consultation up to 5 hour(s)
  • Review of Health Care Policy
  • Review/preparation of document up to 6 pages
Covered $300
Identity Theft Defense Covered $850

 Estate Planning

LegalEASE Plan Coverage

Participating Attorney

LegalEASE Plan Coverage

Non-Participating Attorney

Simple Will or Codicil for:

  • Member
  • Spouse
  • Family Member

Covered

$80

Living Will/Health Care or Advance Directive

Covered

$55

Health Care or Medical Power of Attorney

Covered

$55

Revocable or Irrevocable Living Trust Document Covered $310

Probate of Small Estate

Covered Up to 2 Hours with remainder at 25% discount

$120

Elder Law

LegalEASE Plan Coverage

Participating Attorney

LegalEASE Plan Coverage

Non-Participating Attorney

Elder Parent Will Preparation Covered $80
Elder Parent Living Will/Health Care or Advanced Directive Covered $55 
Elder Parent Durable Financial Power of Attorney Member co-pay $45 per document Not Applicable
Elder Parent Health Care or Medical Power of Attorney Member co-pay $45 per document Not Applicable
Elder Law Matters Covered $425
Residential Matters

LegalEASE Plan Coverage

Participating Attorney

LegalEASE Plan Coverage

Non-Participating Attorney

Purchase of Primary Residence Covered $490
Sale of Primary Residence Covered $365
Refinancing of Primary Residence Covered $385
Vacation or Investment Home Sale/Purchase/Refinancing Covered $425
Home Equity Loan Assistance Covered $360
Property Tax Assessment Covered $360
Tenant Dispute Covered subject to Managed Case Rules* $1,700 maximum subject to Managed Case Rules*
Tenant Security Deposit Dispute Covered $850

Landlord Dispute with Tenant

  • Pre-litigation
  • Trial
  • Pre-litigation: Covered up to 10 hours with remainder at 25% discount
  • Trial: Covered up to 10 hours with remainder at 25% discount
  • Pre-litigation: $595
  • Trial: $595
Security Deposit Dispute with Tenant Covered up to 10 hours with remainder at 25% discount $595
Construction Defect Dispute Covered $425
Neighbor Dispute Covered $765
Noise Reduction Dispute Covered $765
Boundary or Title Dispute Covered $595
Zoning Application Covered $595

Financial Matters

LegalEASE Plan Coverage

Participating Attorney

LegalEASE Plan Coverage

Non-Participating Attorney

Debt Collection Defense

  •  Pre-litigation defense activities
  •  Trial defense

Covered

  • $425
  • $850
Garnishment Defense Covered $850
Bankruptcy (chapter 7 or 13)  Covered $935

Foreclosure

Covered $680

Tax Audit

Covered subject to Managed Case Rules* $1,700 maximum subject to Managed Case Rules*
Tax Defense Covered $850
Student Loan Refinancing/Collection Defense Covered up to 7 hours with remainder at 25% discount $420

Family

LegalEASE Plan Coverage

Participating Attorney

LegalEASE Plan Coverage

Non-Participating Attorney

Separation, Divorce, Civil Annulment

  • Uncontested Separation
  • Consent/default Divorce
  • Uncontested Divorce
Covered $595
Contested Divorce
Covered subject to Managed Case Rules*
$3,400 maximum subject to Managed Case Rules*
Post-Divorce Proceedings
Covered subject to Managed Case Rules*
$3,400 maximum subject to Managed Case Rules*
Prenuptial Agreement Covered $680
Name Change Covered $255

Guardianship/Conservatorship

Uncontested: Covered
Contested: Covered
$365
$765
Governmental Agency Adoption
Uncontested: Covered
Contested: Covered
$365
$765
Stepparent Adoptions
Uncontested: Covered
Contested: Covered
$365
$765
Protection from Domestic Violence Covered $595
Juvenile Court Proceedings Covered $470
School Administrative Proceeding Covered $425
Immigration Assistance Covered up to 10 hours with remainder at 25% discount $595

Civil

LegalEASE Plan Coverage

Participating Attorney

LegalEASE Plan Coverage

Non-Participating Attorney

Civil Litigation Defense Covered subject to Managed Case Rules* $1,700 maximum subject to Managed Case Rules*
Incompetency Defense Covered subject to Managed Case Rules* $1,700 maximum subject to Managed Case Rules*
Discounted Contingency Fees 10% discount on state maximum, or a maximum of 29% pre-trial, 36% at trial, or 40% in an appeal Not Applicable
Mediation 10% discount on Mediator’s hourly rates Not Applicable
Traffic and Administrative Matters

LegalEASE Plan Coverage

Participating Attorney

LegalEASE Plan Coverage

Non-Participating Attorney

Traffic Ticket Covered $215

Serious Traffic Matters (resulting in suspension or revocation of license)

Covered

$425

Administrative Proceeding (Regarding Suspension or Revocation of License)

Covered

$255

Misdemeanor Defense Covered subject to Managed Case Rules* $1,700 maximum subject to Managed Case Rules*
DUI/DWI Defense Covered subject to Managed Case Rules* $1,700 maximum subject to Managed Case Rules*

Limitations apply.

The policy language listed herein is intended to provide a general overview of a typical LegalEASE policy. Please see your LegalEASE policy for specific coverage amounts and exclusions.

* Managed Case Rules

In cases deemed by Us to be complex, Managed Case Rules may be used to approve additional coverage beyond the standard Participating Attorney maximum fees or to ensure that Non-Participating Attorney fees are reasonable and customary. Managed Case Rules provide protection for Members by limiting or preventing additional charges that Members would otherwise be responsible for. Managed Case Rules may be enacted prior to or after the initial consultation. Managed Case Rules require the following:
1. The Member should contact the Member Service Center prior to proceeding with an attorney. If the Member understands from the attorney that there may be additional charges beyond the covered charges under the Policy and the Member does not contact the Member Service Center prior to proceeding with the attorney, then the Member may be responsible for those additional charges beyond the covered charges under the Policy, even on a Paid In Full benefit.
2. If it is determined that the complexity of the case may require additional hours beyond the standard Participating Attorney maximum, or that the Non-Participating Attorney charges are higher than reasonable and customary fees, the attorney must provide a written estimate of fees reflecting his or her best judgment as to the likely cost of legal services based on the expected conduct of the case.
3. We will set a maximum attorney fee that takes into consideration the reasonable level of reimbursement of the proceeding and the proposed litigation strategy. Fees as a result of services in excess of the maximum attorney fee are the responsibility of the Member.
 
 

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 ; any matters involving a government (domestic or foreign) entity or agency; 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, 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 its 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.

 

Definitions

Definitions

“CERTIFICATE OF COVERAGE” means the Certificate of Coverage issued to the Member.

“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 an intellectually disabled 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.

CONTESTED DIVORCE” - refers to a divorce proceeding that requires more than 5 hours of attorney time, involves disputed issues and both parties are represented by an attorney.

“COVERED FAMILY MEMBER” – means the Member’s Covered Spouse and the Member’s unmarried or unpartnered dependent children, including stepchildren, legally adopted children, children placed in the home for adoption and foster children, up to age 26.

“COVERED SPOUSE” - means the Member’s husband/wife as well as his/her same sex civil union partner regardless of what such relationship, which includes substantially all of the rights and benefits of marriage, may have been called in the jurisdiction where it was formed, 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.

“ELIGIBLE PARENT” – means the parents of the Member or Covered Spouse, regardless of age, and includes, biological parents, step-parents and adoptive parents.

“HEALTH CARE COVERAGE” – means coverage of a Member under any health care or health insurance policy or any policy that covers as its primary function any aspect of an individual’s health.

“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.

“INTERNET PURCHASE” - A purchase of goods or services whose cost is over $200.00 at the time of purchase by a Member from a website on the Surface Web, as defined.

“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.

“NEIGHBOR” – A person whose residence is located on a property that directly abuts the property on which a Member’s residence is located.

“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.

“PERSONAL PROPERTY” – means any property that is not Real Property and which does not produce income.

POLICY” - means the Group Legal Expense Insurance Policy and the Certificate of Coverage.

“POLICYHOLDER” - means the organization named in the declarations page.

“REAL PROPERTY” – means land and all permanent structures attached thereto.

“SURFACE WEB” – means the portion of the World Wide Web that is readily available to the general public and searchable via standard web search engines.

“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 as stated on the Declaration Page of the Certificate of Coverage, 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

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.

This benefit is limited to the maximum number of hours shown on the Schedule of Benefits per year and may only be used for a single legal matter.

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. (excluding those reviewed or prepared under the real estate benefit)
  • Promissory Note
  • Consumer Dispute Correspondence

 

  • Installment Sales Agreement
  • Simple Affidavit
  • General Power of Attorney
  • Lease Agreement (for the Member/Covered Family Member as a tenant only)
  • Time Share Agreement
 
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).

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).

Mail Order or Internet Purchase Dispute:

The services of an attorney to review the nature of any mail order or Surface Web Internet Purchase dispute involving the purchaser prior to the commencement of litigation. This service includes the consultation with the attorney and review and/or preparation of purchase documents and/or dispute letters. If litigation is commenced in this matter, the benefit will cover up to the maximum shown on the Schedule of Benefits.

Bank Fee Dispute:

The services of an attorney to review the nature of any (non-business related) bank fee dispute between the Member and their bank prior to the commencement of litigation. This service includes the consultation with the attorney and review and/or preparation of purchase documents and/or dispute letters. If litigation is commenced in this matter, the benefit will cover up to the maximum shown on the Schedule of Benefits.

First-time Vehicle Buyer:

The services of an attorney for the purchase of a first vehicle. This service includes the consultation with the attorney at or before closing and/or review and/or preparation of purchase and finance documents.

Vehicle Repair and Lemon Law Litigation:

Services related to the representation of a Member who is entitled under the applicable state “lemon” law to bring a civil lawsuit (non-business related), up to and including the trial thereof related to a defective car as defined in the applicable state law. This benefit does not apply to: (1) any lawsuit related to matters that are not specifically listed under the provisions of the applicable state fraud laws; (2) lawsuits normally handled on a contingent fee basis; (3) any action for or defense against a collection or related matter; or (4) matters for which the Member has or is required by law to have insurance.

Cell Phone Contract Dispute:

Review of the cell phone contract where the attorney will verbally explain the meaning or impact of any form or document, or make suggestions for changes to a form or document being drafted, of up to maximum number of pages shown on the Schedule of Benefits.

In the event of a dispute over the terms of the agreement between the cell phone company and the Member, this benefit provides for representation in a dispute relating to the cell phone contract only if the Member has been sued or named in a small claims court action. This service covers counseling on prosecuting a small claims court action; helping the Member prepare documents; advising on evidence, documentation and witnesses; and preparing the Member for trial. The service does not include the attorney’s attendance or representation at a small claims trial, collection activities after a judgment or any services relating to post-judgment actions.

Personal Property Protection:

Services cover counseling over the phone or in the office on any Personal Property issue, including consumer credit reports, contracts for the purchase of Personal Property, consumer credit agreements or installment sales agreements. Counseling on pursuing or defending small claims actions is included. The benefit includes reviewing personal legal documents and preparing promissory notes, affidavits and demand letters.

Warranty Dispute:

Review of the warranty policy or service contract where the attorney will verbally explain the meaning or impact of any form or document, or make suggestions for changes to a form or document being drafted, up to the maximum number of pages shown on the Schedule of Benefits.

In the event of a dispute over the terms of the agreement between the warranty company and the Member, this benefit provides representation in a dispute relating to the warranty or service contract only if the Member has been sued or named in a small claims court action. This service covers counseling on prosecuting a small claims court action; helping the Member prepare documents; advising on evidence, documentation and witnesses; and preparing the Member for trial. The service does not include the attorney’s attendance or representation at a small claims trial, collection activities after a judgment or any services relating to post-judgment actions.

Health Care Coverage Dispute and Records:

Up to the maximum as shown in the Schedule of Benefits for office consultations with an attorney on any Health Care Coverage dispute, civil or criminal, involving a coverage, benefits, or privacy matter that arose while the health care or health insurance policy was in effect (as defined by the terms of that health care or health insurance policy). For a definition of Health Care Coverage, please see the Definitions section.

This benefit is designed to help the Member understand health care law provisions and coverages based on the federal and/or state version of this law AAPACA, and to prepare a bona fide defense to any denials in coverage valued at more than $1,000.00 in covered medical services under the policy in dispute. This benefit is not intended to provide representation in litigation and does not include collection defense or other actions related to medical bills or payments.

This benefit also includes the review of simple health care policy coverage documents and the attorney will verbally explain the meaning or impact of any policy or related document, or make suggestions for dispute letters or documents 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 or explanation of any form or document but does include the preparation of any of the following documents, up to the maximum number of pages shown on the Schedule of Benefits: policyholder dispute correspondence, and simple affidavit. Partial documents cannot be reviewed or prepared, and if the document other than the actual health care coverage policy is more than the maximum number of pages shown in the Schedule of Benefits, the benefit does not apply.

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.

 

Estate Planning

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.

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.

Revocable or Irrevocable Living Trust Document:

Preparation of a revocable or irrevocable living trust for either the Member, Covered Spouse, or a combined living trust document.

This benefit does not include services related to transactions to fund the trust or transfer assets into it. This benefit does not include tax planning or tax advice.
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.

 

Elder Matters

Elder Parent Will Preparation:

Each Eligible Parent may receive one Simple Will per year at no charge. The attorney will prepare the document and discuss the legal requirements for signing the will. This benefit does not cover Complex Wills, as defined in the Definitions section.

Elder Parent Living Will/Health Care or Advance Directive:

Each Eligible Parent may request one Living Will/Health Care or Advance Directive, as they are defined in the Definitions section, per year at no charge. The attorney will prepare the documents as authorized by state law and discuss the legal requirements for signing the Living Will/Health Care or Advance Directive. The titles of the above documents may vary by state.

Elder Parent Durable Financial Power of Attorney:

Each Eligible Parent may request one Durable Financial Power of Attorney, as defined in the Definitions section, per year at the co-pay rate shown in the Schedule of Benefits. The attorney will prepare the document as authorized by state law and discuss the legal requirements for signing the Durable Financial Power of Attorney. The titles of the above documents may vary by state.

Elder Parent Health Care or Medical Power of Attorney:

Each Eligible Parent may request one Health Care or Medical Power of Attorney, as they are defined in the Definitions section, per year at the co-pay rate shown in the Schedule of Benefits. The attorney will prepare the document as authorized by state law and discuss the legal requirements for signing the Health Care or Medical Power of Attorney. The titles of the above documents may vary by state.

Elder Law Matters:

This service covers counseling the Member over the phone or in the office on any personal issues relating to the Eligible Parents as they affect the Member. This benefit includes reviewing documents of the Eligible Parents to advise the Member of the legal effect on the Member. The documents include Medicare or Medicaid materials, prescription plans, leases, nursing home agreements, powers of attorney, living wills and wills. The benefit also includes preparing deeds involving the Eligible Parents when the Member and/or Covered Spouse is either the grantor or grantee; and preparing promissory notes involving the parents when the Member and/or Covered Spouse is either the payor or payee.



Residential Matters

Real Estate Sale, Purchase or Refinancing of Primary Residence:

The services of an attorney for the sale, purchase or refinancing of a primary residence (where Member has resided or intends to reside for twenty-seven (27) weeks or more per year). This service includes the review and/or preparation of closing documents and/or attendance by the attorney at closing in situations when it is customary for the attorney to do so. This benefit does not include services performed by or for a title company, or for an attorney acting on behalf of a lending institution. Home equity loans and the sale or purchase of unimproved or rental properties are not included.

Vacation or Investment Home Purchase, Sale or Refinancing:

The services of an attorney for the purchase, sale, or refinancing of a vacation or investment residence (where Member has not resided or does not intend to reside for twenty-seven (27) weeks or more per year). This service includes the review and/or preparation of closing documents and/or attendance by the attorney at closing in situations when it is customary for the attorney to do so. This benefit does not include services performed by or for a title company, or for an attorney acting on behalf of a lending institution. Home equity loans and the sale or purchase of unimproved properties are not included.

Home Equity Loan Assistance for Primary Residence:

The services of an attorney for the review and/or preparation of a home equity loan on a primary residence , or second or vacation home. This benefit does not include services performed by or for a title company, or for an attorney acting on behalf of a lending institution.

Property Tax Assessment:

The services of an attorney for review and advice on a property tax assessment on a primary residence (where Member has resided or intends to reside for twenty-seven (27) weeks or more per year). This benefit includes filing the paperwork, gathering the evidence, negotiating a settlement, and attending the hearing necessary to seek a reduction of the assessment.

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.

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.

Landlord Dispute with Tenant:

This benefit covers the Member where he/she is a landlord, but where the regular business or livelihood of the Member is that other than a landlord, for matters involving evictions, leases, or disputes with a residential tenant. The service includes advice and representation if a lawsuit is filed up to the maximum shown on the Schedule of Benefits. This benefit does not include representation for a tenant in disputes with other tenants or for a tenant acting in his/her capacity as sublessee or sublessor. If a lawsuit is required in order for the landlord to recover his or her damages, then representation will be provided up to the maximum shown in the Schedule of Benefits and the Member will be responsible for paying all fees for any additional services required.

Security Deposit Dispute with Tenant:

This benefit covers the Member where he/she is a landlord , but where the regular business or livelihood of the Member is that other than a landlord, in defending against the recovery of a security deposit from the Member’s residential tenant for any residence owned and leased by the Member; reviewing the lease and other relevant documents; and preparing a letter to the tenant specifying what part of the deposit, if any, will not be returned. It also covers assisting the Member in defending 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.

Construction Defect Dispute:

The services of an attorney in a dispute relating to a defect or damage caused by the construction of the Member’s new primary residence (where Member has resided or intends to reside for twenty- seven (27) weeks or more per year), purchased within the past five (5) years up to the maximum shown in the Schedule of Benefits.

Neighbor Dispute:

The services of an attorney in a dispute relating to a Member’s Neighbor up to the maximum shown in the Schedule of Benefits. For a definition of Neighbor, please see the Definitions section. Advice and/or preparation and assistance for a dispute filed in court is covered, although representation in small claims court is not covered.

 

Noise Reduction Dispute:

The services of an attorney in a dispute relating to a Member’s enjoyment of his/her residence, where any activity related to noise affecting the Member’s enjoyment of their home is prohibited by federal, state or local law, up to the maximum shown in the Schedule of Benefits. Advice and/or preparation and assistance for a dispute filed in court is also covered, although representation in small claims court is not covered.

Boundary or Title Dispute:
Services needed to negotiate and/or litigate matters arising from boundary or Real Property title disputes involving the Member’s primary or secondary or vacation residence and where coverage is not available under the Member’s homeowner or title insurance policies. This benefit includes filing to remove a mechanic’s lien. This benefit does not include boundary or title issues related to business assets or property. This benefit does not include boundary or title issues arising from the assertion of Eminent Domain.
Zoning Application:
Services needed to negotiate and/or litigate the change of zoning or variance for the Member’s primary or secondary or vacation residence. This benefit applies to the Member as a plaintiff or defendant. This benefit includes research and review of the law, surveys, advising the Member, preparing applications, and preparing for and attending the hearing. This benefit does not include zoning or variance issues related to business assets or property.
 
 
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.
Garnishment Defense:
The defense of any dispute involving wage or earnings garnishment to collect on a court-ordered judgment related to personal (non-business related) goods or services. This benefit includes correspondence, negotiating with the court or opposing party to arrange a repayment schedule, assistance in limiting harassment by bill collectors, negotiating settlement after a complaint is filed, and representation at trial, if necessary. This service does not include efforts to vacate or set aside a judgment.
Bankruptcy:
Representation on behalf of the Member for personal (non-business related) bankruptcy protection under Chapter 7 or 13 of the Internal Revenue Code.
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.)
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.
Tax Defense:
The defense of any dispute involving the collection of personal (non-business related) debt by a state or federal tax agency. This benefit includes correspondence, negotiating with the creditor tax agency to arrange a repayment schedule, assistance in limiting harassment by bill collectors, negotiating settlement after a complaint is filed, and representation at trial, if necessary. This service does not include defense against execution of a court-ordered judgment or efforts to vacate or set aside a judgment. This service does not include counter, cross or third-party claims; bankruptcy; any action arising out of family law matters, including support and post-decree matters; or any matter where the creditor is affiliated with the Policyholder.
Student Loan Refinancing/Collection Defense:
The services of an attorney up to the maximum shown in the Schedule of Benefits for a student loan refinancing or collection dispute proceeding. This benefit includes negotiation with creditors for a repayment schedule and to limit creditor harassment, and representation in defense of any action for personal debt collection, tax agency debt collection, foreclosure, repossession or garnishment, all related to one or more school loans up to and including trial if necessary.
This benefit does not include: vacating a judgment; counter, cross or third-party claims; bankruptcy, any action arising out of family law matters, including support and post decree issues; or any matter where the creditor is affiliated with the sponsor or employer.
 
 
Family Matters
Separation, Divorce, Civil Annulment:
Legal representation of the Member for up to the maximum shown on the Schedule of Benefits in an uncontested separation or civil annulment; consent or default divorce, uncontested divorce or Contested Divorce. An uncontested separation, divorce or civil annulment does not involve significant disputed issues and the parties resolve any issues prior to any court supervised proceeding. A consent or default divorce does not involve any disputed issues and the opposing party is not represented by counsel. The benefit for uncontested matters does not provide any coverage of an attorney’s fee for:
(1) services in excess of the maximum shown on the Schedule of Benefits; the Member must pay the attorney’s fee for services in excess of the maximum; or (2) contested matters in which case the Member must pay the attorney’s fee for services, unless the coverage includes contested matters and the benefit shall be in accordance with the Schedule of Benefits. A contested separation, divorce or civil annulment requires more than five hours of attorney time, involves disputed issues and requires that both parties be represented by an attorney.
This benefit is limited to two uses per year (representation seeking or defending against interim order shall constitute a separate use). This benefit applies to the Member only and Covered Family Members only for actions not involving the Member as an opposing party.
Post-Divorce Proceedings:
Legal representation of the Member for up to the maximum listed on the Schedule of Benefits in a contested or uncontested post-divorce proceeding. An uncontested post-divorce proceeding does not involve significant disputed issues and the parties resolve any issues prior to any court supervised proceeding. The benefit for uncontested matters does not provide any coverage of an attorney’s fee for: (1) services in excess of the maximum listed on the Schedule of Benefits; the Member must pay the attorney’s fee for services in excess of the maximum; (2) contested matters in which case the Member must pay the attorney’s fee for services, unless the coverage includes contested matters and the benefit shall be in accordance with the Schedule of Benefits. A contested post-divorce proceeding requires more than five hours of attorney time, involves disputed issues and requires that both parties be represented by an attorney. This benefit includes custody, support, and alimony proceedings.
This benefit is limited to two uses per year. This benefit applies to the Member only and Covered Spouse only for actions not involving the Member as an opposing party.
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.
Name Change:
Services required to accomplish a legal name change for a 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 another. This benefit does not include fees for a court-appointed attorney for the child/conservatee.
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. If the amount of an attorney’s time for uncontested adoption exceeds the maximum shown in the Schedule of Benefits, or if the adoption becomes contested, then coverage will terminate and the Member will be responsible for any additional legal fees.
Protection from Domestic Violence:
Services needed to assist the Member only, in obtaining a protective order arising from a domestic violence or abuse matter, including all required paperwork and attendance at all court appearances. This benefit does not include representation in suits for damages, defense of any action, or representation of the offender.
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.
School Administrative Proceeding:
Services needed for a dependent child of a Member/Covered Family Member for consultations, and review or help with preparation of documents prior to the representation of the dependent child in any school administrative proceeding (not including expulsion), 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 the school in which the child is officially enrolled. This benefit does not contemplate any attendance or representation by the attorney at or prior to any administrative hearing or appearance.
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 benefit also extends to the Member’s Covered Family Members and non-covered family members 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.
Incompetency Defense:
Services related to the representation of a Member in the defense of any incompetency action, including court hearings when there is a proceeding to find the Member incompetent.
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:
This benefit does not include the cost of the mediator’s services.


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.

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 not cover violations related to a commercial driver’s license.
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.
Misdemeanor Defense:
Defense of a Member in connection with criminal misdemeanor charges (not associated with any felony charge).
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 does not include misdemeanors relating to a commercial driver’s license. This benefit does not include adjustments to probation or parole.

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. If a Member has a Non-Participating Attorney he or she would prefer to work with, the Member must notify the representative of his/her intention to use a Non-Participating Attorney for a Covered Service. The Member will receive a claim form from the Member Service Center within fifteen (15) days of notice. 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. Failure to submit a claim to the Member Service Center within sixty (60) days or as soon as reasonably possible following consultation with an attorney may result in a denial of benefits.

 

  1. To confirm coverage for matters to which Managed Case Rules apply reference Managed Case Rules in the Schedule of Benefits.

 

  1. Members and/or Covered Family Members who are requesting services must remain enrolled and continue to pay premium hereunder.
  2. 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.

  1. If the Member/Covered Family Member pays for pre-authorized services provided by a Non- Participating Attorney, the Member must submit a claim 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 or as soon as reasonably possible. Reimbursement for covered legal services will be payable not more than sixty (60) days upon receipt of proof of loss. Benefits provided to the Member/Covered Family Member for Covered Services are subject to the maximum as shown in the Schedule of Benefits.

 

  1. 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 ; any matters involving a government (domestic or foreign) entity or agency; 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, 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 its 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.

Beneficiary Provision

All benefits will be payable to the Member or in the case of death, to the Member’s estate. No person or entity other than the Member shall have any legal or equitable right, remedy or claim of insurance proceeds or damages under or arising out of this coverage.

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.

Termination and Cancellation of Coverage

Coverage provided to the Member shall terminate upon the first of the following to occur:

 

  1. Cancellation or termination of the Group Policy;
  2. If applicable, the Member fails to re-enroll;
  3. The Member is no longer associated with Policyholder; or
  4. The Member fails to pay his or her premium to the Policyholder for remittance to the Company when due, subject to the Grace Period provision.

 

Coverage provided to a Covered Family Member of a Member shall terminate upon the first of the following to occur:

  1. The Member’s coverage is cancelled or terminated; or
  2. The family member ceases to qualify as a Covered Family Member as defined.

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.

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.

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.

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.

Legal Action Against Us

No action at law shall be brought against Us for payment of claim: (1) less than sixty (60) days after due proof of claim is furnished; or (2) more than 3 years after the date proof of claim is required by the Policy.

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.

 

Network

About the Network of Attorneys
When going in for surgery, you don’t want a surgeon that has a poor track record or only a couple years experience. We feel that a legal need is just as important.
 
Help Focus Infrastructure
When it comes to finding an attorney, an employee can waste days looking for the right one, even with a legal plan. Our process has a Help Focus Infrastructure. We focus on our relationships with our Providers to help us help your employees, faster. Our Attorney Match Technology and dialogue with attorneys and members ensures the right help the first time. Matching an employee to the right help expedites solutions while saving time and stress.
 
Standards and Qualifications
The credentialing standards that we utilize to vet our providers is the most stringent in the country. We focus on years of experience, as well as insurance and discipline, as well as penalty of perjury submissions with extensive back ground checks.
 
Under the Provider Network, your employees will receive legal help from professionals with many of these service characteristics:
  • Experience in the Legal Matter Needed
  • Quality Time Spent in Consultations
  • Years of Legal Training and Experience
  • Up-to-date Legal Training Each Year
  • Lawyers Who are Service-Oriented
  • Lawyers Who Have a Solid Local Reputation in their Communities
  • Exceptional Backgrounds
  • Years of Courtroom and Trial Experience
Provider Standards of Care
The Network Provider shall strive to provide the highest quality of legal representation and service to Plan Members.
 
Plan Providers agree to the following:
  • To comply at all times with the Rules of Civil Procedure and Criminal Procedure and the Rules of Professional Conduct applicable to the jurisdiction.
  • To return member's calls promptly, within one business day, and communicate with members such that a member and the member's family do not voice substantiated concerns over promptness or frequency of your or your firm's communication.
  • To not enter continuances, adjournments, or the like without the member's comfort and consent.
  • To not arrange for substitutions or stand-ins unless the member has been previously advised and that the member understands that you remain responsible for the case and to contact you if there is any concern or if proceedings do not go as planned.
  • To always respect a member, their needs and family.
  • To maintain a professional office, in staffing and appearance.
  • To fully explain yourself such that a member has an understanding for the reasons behind your recommendations and suggestions, even if a member may not hire your firm.
  • To not complete any additional work that will result in a fee to the member, where not covered by the member's plan, until a fee arrangement is fully understood by the member and there is a written agreement.
  • To help each member individually and ensure that everything you do is in the interest of the member.
  • To notify LegalEASE if there is or may be the possibility of a conflict of interest or violation of ethical codes.
  • To notify LegalEASE if there may be a misunderstanding or potential service issue where there may be a complaint without breaking any client confidences.
  • To direct any grievances or concerns, such as process procedure or billing, to Legal Access and not a member.
  • To not refer any member to another attorney without the knowledge and consent of Legal Access if you cannot assist.
  • To take responsibility and uphold the highest standards of customer service delivered by any and all firm staff or employees that have interaction with members.
  • To communicate and cooperate with LegalEASE on any concern, inquiry or issue and return any communication from Legal Access within one business day.

 

About

We are here to serve you...

 

We believe people deserve to have a sense of safety and security, a peace of mind, when it comes to being protected in legal matters that they may not be the experts in. To have access to legal professionals that can ease and solve their legal burdens. We are here to serve you.

 

How we do it is by providing an in-depth pool of resources to accommodate all your legal needs. Legal Access and LegalEASE have broad experiences with employees in small, medium and large companies in the public and private sectors, local, state and federal government offices, unions, employee assistance plans, work-life companies, and organizations, when it comes to solving your legal matters.

 

What we do is provide value by creating unparalleled access to a network of skilled attorneys to cover your legal needs with options in convenient plans. We are a diversified employee benefits company engaged in administration, network development, technology management and insurance, based in Houston, Texas. Since 1971, we have grown from five attorneys in Los Angeles providing services to a modest amount of companies into a company with the strongest attorney network across America. We provide assistance to members over half of a million times each year throughout the United States and the world.

 

Legal Access Companies consists of several companies and brands to best meet customer needs, including but not limited to: Legal Plans USA, Legal Access Plans, LegalEASE, and LAMG. Legal Access Plans has a wide array of products across several market segements, including worksite, employee assistance and worklife. LegalEASE is the group's primary insurance brand and focuses primarily in the worksite market. LegalEASE products are underwritten and presented by Virginia Surety Company, part of the Warranty Group.