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Benefits Proudly Offered to Intra-Cellular Therapies, Inc.
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.
- 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 $18.50 monthly, via payroll deduction.
Who's Covered?
The Member’s spouse and Member’s unmarried 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 per calendar year
|
Covered |
Not Applicable |
Review of Simple Documents
Review of documentation up to 6 pages
|
Covered |
Not Applicable |
Simple Dispute Resolution Correspondence | 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 up to 10 hours per year |
Covered
|
$60/hour |
Discounted Legal Services for any non-excluded legal matter | 25% Discount on Attorney's Hourly Rates | Not Applicable |
Consumer Matters |
LegalEASE Plan Coverage Participating Attorney |
LegalEASE Plan Coverage Non-Participating Attorney |
Document Preparation:
|
Covered |
|
Consumer Dispute |
Covered |
$595 |
Small Claims Court Reprsentation |
Covered |
$300 |
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
|
Covered | $300 |
Personal Property Protection | Covered | $300 |
Warranty Dispute
|
Covered | $300 |
Healthcare Coverage Disputes and Records
|
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:
|
Covered |
$80 |
Complex Will | Covered | $310 |
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 |
Funeral Directive | Covered | $55 |
Hospital Vistation Authorization | Covered | $55 |
Probate of Small Estate |
Covered subject to Managed Case Rules* |
$1,275 maximum subject to Managed Case Rules* |
Medicare/Medicaid/Social Security Proceeding | Covered | $850 |
Social Security Administration Benefit Appeal | Covered | $850 |
Veterans Benefits Appeal | Covered | $720 |
Elder Matters |
LegalEASE Plan Coverage Participating Attorney |
LegalEASE Plan Coverage Non-Participating Attorney |
Will Preparation | Covered | $80 |
Living Will/Health Care or Advanced Directive | Covered | $55 |
Durable Financial Power of Attorney | Member co-pay $45 per document | Not Applicable |
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 |
First Time Home-Buyer | Covered | $425 |
Vacation or Investment Home Sale/Purchase/Refinancing | Covered | $425 |
Home Equity Loan Assistance | Covered | $360 |
Property Tax Assessment | Covered | $360 |
Property Tax Dispute | 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
|
|
|
Security Deposit Dispute with Tenant | Covered up to 10 hours | $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 |
Real Estate Dispute | Covered subject to Managed Case Rules* | $1,700 maximum subject to Managed Case Rules* |
HOA/COA/POA/Co-Op Board Dispute or Defense | Covered | $595 |
Financial Matters |
LegalEASE Plan Coverage Participating Attorney |
LegalEASE Plan Coverage Non-Participating Attorney |
Debt Collection Defense
|
Covered |
|
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
|
$420 |
Repossession Defense | Covered | $850 |
Family |
LegalEASE Plan Coverage Participating Attorney |
LegalEASE Plan Coverage Non-Participating Attorney |
Separation, Divorce, Civil Annulment
|
Covered | $595 |
Contested Divorce |
Covered up to 28.5
hours
|
$1,700 maximum subject to Managed Case Rules* |
Post-Divorce Proceedings |
Covered up to 28.5
hours
|
$1,700 maximum subject to Managed Case Rules* |
Domestic Partnership Agreement | Covered | $320 |
Prenuptial Agreement | Covered | $680 |
Name Change | Covered | $255 |
Gender Identifier Change | Covered | $240 |
Egg/Sperm/Embryo Donation Agreement | Covered | $480 |
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
|
Child Custody/Support Involving Never-Married Parents of a Child | Covered Up to
28.5 Hours
|
$1,700 maximum subject to Managed Case Rules* |
Paternity Proceeding | Covered | $595 |
Stalking Victim Assistance | Covered | $595 |
Protection from Domestic Violence | Covered | $595 |
Juvenile Court Proceedings | Covered | $470 |
School Administrative Proceeding | Covered | $425 |
Immigration Assistance | Covered up to
10 hours
|
$595 |
Parental Responsibility Matters | Covered | $595 |
Civil Matters |
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* |
Administrative Hearing Representation | Covered subject to Managed Case Rules* | $1,275 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 |
Criminal Defense |
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 |
Habeas Corpus Proceedings | Covered | $850 |
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 requiring more attorney time than covered by the standard Participating Attorney maximum fee, Managed Case Rules may be used to approve additional coverage beyond the standard Participating Attorney maximum fees. They are also used to ensure that Non-Participating Attorney fees are reasonable and customary. Managed Case Rules provide protection for You by limiting or preventing additional charges that You would otherwise be responsible for. Managed Case Rules may be enacted prior to or after the initial consultation. Managed Case Rules require the following:
- You should contact the Member Service Center prior to proceeding with an attorney. If You understand from the attorney that there may be additional charges beyond the covered charges under the Policy call the Member Service Center. If You do not contact the Member Service Center prior to proceeding with the attorney, then You may be responsible for those additional charges beyond the covered charges under the Policy, even on a Paid In Full benefit.
- 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.
- 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 Your responsibility.
Exclusions
Definitions
DEFINITIONS
“CLAIMS ADMINISTRATOR” - means LegalEASE; or its subsidiary.
“COMPLEX WILL” – means:
(a) You have a significant net worth and will benefit from tax planning, or
(b) the estate is subject to current state or federal estate taxation; or
(c) You own a business that will continue in operation after death; or
(d) You want to put restrictions on what heirs may do with the property; or
(e) You want to leave money to someone in a trust because the person cannot manage his or her own affairs (such as a mentally handicapped child), or
(f) You want 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
(g) You think that someone will challenge the will; or
(h) You want to exclude any lawful dependents.
The inclusion of a pour-over provision in a will does not, by itself, make a will complex.
VSC_LP_B1_DEF_CW (202103)
“COVERED FAMILY MEMBER” – means Your spouse/domestic partner and Your or Your spouse/domestic partner's dependent children, including stepchildren, legally adopted children, children placed in the home for adoption, foster children, and children who are under sole legal guardianship of You or spouse/domestic partner up to age 26.
VSC_LP_B1_DEF_CFM-6 (202103)
“DOMESTIC PARTNER” – means Your domestic/civil union partner as defined by the jurisdiction in which You primarily resides.
VSC_LP_B1_DEF_DP (202103)
“EFFECTIVE DATE” - means the date Your coverage hereunder begins.
“ELIGIBLE PARENT” – means Your or Covered Spouse’s parents, regardless of age. It includes, biological parents, step-parents and adoptive parents.
VSC_LP_B1_DEF_EP (202103)
“HEALTH CARE COVERAGE” – means Your coverage under any health care or health insurance policy. It also means any policy that covers as its primary function any aspect of an individual’s health.
VSC_LP_B1_DEF_HCC (202103)
“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.
VSC_LP_B1_DEF_HCPOA (202103)
“INTERNET PURCHASE” - A purchase of goods or services whose cost is over $200.00 at the time You purchase from a website on the Surface Web.
VSC_LP_B1_DEF_IP (202103)
“LEGAL PLAN ADMINISTRATOR” – LegalEASE,
(a) its affiliates, officers, directors, employees, and/or
(b) agents, including third party organizations and their affiliates, officers, directors, employees, and/or
(c) 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. This document takes effect when the individual becomes incapacitated and can no longer express his or her wishes.
VSC_LP_B1_DEF_LW (202103)
“MEMBER” - refers to the individual who
(a) is associated with the Policyholder and/or Plan Sponsor,
(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 You/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 Your residence is located.
VSC_LP_B1_DEF_NEI (202103)
“NON-PARTICIPATING ATTORNEY” - means an attorney not contracted by the Legal Plan Administrator who:
- is selected and
- paid by the You
to provide covered legal services.
Covered legal services are provided up to the maximum amount shown under the Non-Participating Attorney column of the Schedule.
“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. Covered legal services are provided up to the amount shown under the Participating Attorney column of the Schedule.
“PERSONAL PROPERTY” – means any property that is not Real Property and which does not produce income.
VSC_LP_B1_DEF_PPROP (202103)
“PLAN SPONSOR” - means an organization other than the Policyholder or the Your employer that makes coverage hereunder available.
“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.
VSC_LP_B1_DEF_RP (202103)
“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.
VSC_LP_B1_DEF_SW (202103)
“WE”, “US”, “OUR” AND “COMPANY” - means Virginia Surety Company, Inc.
“YOU” AND “YOUR” – means Member.
VSC_LP_B1 (202103)
“WAITING PERIOD” – means the period after the Effective Date during which certain benefits as shown in the Schedule may not be used. This includes any matter that arises prior to the end of the Waiting Period.
VSC_LP_B1_DEF_WP (202103)
COVERED SERVICES
In consideration of payment and receipt by Us of the applicable premium, all Covered Services are available to You and all Covered Family Members, except as specifically noted below. The following Covered Services are provided when You use a Participating Attorney. The Schedule chart shows the reimbursement schedule when You use a Non-Participating Attorney.
VSC_LP_C1 (202103)
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, except those specifically excluded.
VSC_LP_C1_CS_M_000-2 (202103)
Initial Law Office Consultation:
Office consultations with an attorney on any personal legal problem, except those specifically excluded.
VSC_LP_C1_CS_M_001 (202103)
Review of Simple Documents:
This benefit includes:
(a) attorney review,
(b) verbal explanations of the meaning or impact of any form or document, or
(c) suggestions for changes to a form or proposed document being drafted
of up to the maximum number of pages as shown in the Schedule.
This benefit does not include a written analysis of any form or document.
VSC_LP_C1_CS_M_002 (202103)
Simple Dispute Resolution Correspondence:
This benefit includes attorney services to attempt to resolve a simple dispute through
(a) phone calls or
(b) letters
to the opposing party in matters where such action, at the discretion of the attorney, can be expected to result in a favorable outcome for You.
This benefit includes up to three:
(a) letters or
(b) phone calls
per dispute.
This benefit is limited to the maximum number of disputes as shown in the Schedule.
This benefit does not include:
(a) complex disputes or
(b) those where the attorney anticipates that the matter is very likely to escalate to litigation.
VSC_LP_C1_CS_M_003 (202103)
Miscellaneous Law Office Services
Legal Services for any Non-Excluded Legal Matter:
This benefit will cover any legal services to:
(a) review and/or prepare documents, or
(b) any other service required on any legal matters not listed as a Covered Service or Exclusion.
This benefit may not be used to extend the coverage for any other service shown in the Schedule beyond the limits of coverage.
This benefit is limited to the maximum number of hours shown on the Schedule per year and may only be used for a single legal matter.
VSC_LP_C1_CS_M_105-4 (202103)
Discounted Legal Services for any Non-Excluded Legal Matter:
This benefit will cover any legal services to
(a) review and/or prepare documents, or
(b) any other service required on any legal matters not listed as a Covered Service or Exclusion.
This benefit may not be used to extend the coverage for any other service shown in the Schedule beyond the limits of coverage.
VSC_LP_C1_CS_M_004-2 (202103)
Consumer Matters
Document Preparation:
Preparation of any of the following documents:
VSC_LP_C1_CS_M_005 (202103)
- Simple Deed (excluding those reviewed or prepared under the real estate benefit) This benefit is limited to one use per year.
VSC_LP_C1_CS_M_210-3 (202103)
- Promissory Note: This benefit is limited to one use per year.
VSC_LP_C1_CS_M_220-3 (202103) - Consumer Dispute Correspondence: This benefit is limited to one use per year.
VSC_LP_C1_CS_M_230-3 (202103)
- Installment Sales Agreement: This benefit is limited to one use per year.
VSC_LP_C1_CS_M_240-3 (202103)
- Simple Affidavit: This benefit is limited to one use per year.
VSC_LP_C1_CS_M_250-3 (202103)
- General Power of Attorney: This benefit is limited to one use per year and can be used for either a General, Limited, or Durable Financial Power of Attorney.
VSC_LP_C1_CS_M_310-3 (202103)
- Lease Agreement (for You/Covered Family Member as a tenant only). This benefit is limited to one use per year.
VSC_LP_C1_CS_M_320-3 (202103)
- Time Share Agreement: This benefit is limited to one use per year.
VSC_LP_C1_CS_M_330-3 (202103)
Consumer Dispute:
Consultation or representation in a dispute relating to consumer goods and services (not directly or indirectly related to
(a) real estate construction or renovation, or
(b) landlord/tenant disputes).
This benefit is limited to one use per year.
VSC_LP_C1_CS_M_360-4 (202103)
Small Claims Court Representation:
Consultation and/or representation for a dispute filed in small claims court. (Attorney may not be permitted to attend court hearings in some jurisdictions).
This benefit is limited to one use per year.
VSC_LP_C1_CS_M_390-4 (202103)
Mail Order or Internet Purchase Dispute:
The services of an attorney to review the nature of any:
(a) mail order or
(b) Surface Web Internet Purchase
dispute involving the purchaser prior to the commencement of litigation.
This service includes:
(a) the consultation with the attorney and review and/or
(b) preparation of purchase documents and/or
(c) dispute letters.
This benefit is limited to one dispute per year.
VSC_LP_C1_CS_M_363-4 (202103)
Bank Fee Dispute:
The services of an attorney to review the nature of any (non-business related) bank fee dispute between You and Your bank prior to the commencement of litigation. This service includes:
(a) the consultation with the attorney and
(b) review and/or preparation of purchase documents and/or dispute letters.
This benefit is limited to one dispute per year.
VSC_LP_C1_CS_M_364-4 (202103)
First-time Vehicle Buyer:
The services of an attorney for the purchase of a first vehicle. This service includes:
(a) the consultation with the attorney at or before closing and/or
(b) review and/or preparation of purchase and finance documents.
This benefit is limited to one vehicle purchase per year and must be Your/Covered Family Member’s first vehicle purchase.
VSC_LP_C1_CS_M_365-2 (202103)
Vehicle Repair and Lemon Law Litigation:
Services related to Your representation when 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:
(a) any lawsuit related to matters that are not specifically listed under the provisions of the applicable state fraud laws;
(b) lawsuits normally handled on a contingent fee basis;
(c) any action for or defense against a collection or related matter; or
(d) matters for which You have or are required by law to have insurance.
This benefit is limited to one use per year.
VSC_LP_C1_CS_M_366-2 (202103)
Cell Phone Contract Dispute:
Review of the cell phone contract where the attorney will
(a) verbally explain the meaning or impact of any form or document or
(b) make suggestions for changes to a form or document being drafted,
of up to maximum number of pages shown on the Schedule.
This benefit does not include:
(a) a written analysis or
(b) explanation
of any form or document.
In the event of a dispute over the terms of the agreement between the cell phone company and You, this benefit provides for representation in a dispute relating to the cell phone contract only You have been sued or named in a small claims court action. This service covers:
(a) counseling on prosecuting a small claims court action;
(b) helping You prepare documents;
(c) advising on evidence, documentation and witnesses; and
(d) preparing You for trial.
The service does not include:
(a) the attorney’s attendance or representation at a small claims trial,
(b) collection activities after a judgment or
(c) any services relating to post-judgment actions.
This benefit is limited to one use per year.
VSC_LP_C1_CS_M_367-4 (202103)
Personal Property Protection:
Services cover counseling over the phone or in the office on any Personal Property issue, including:
(a) consumer credit reports,
(b) contracts for the purchase of Personal Property,
(c) consumer credit agreements,
(d) installment sales agreements,
(e) pursuing or defending small claims actions.
The benefit includes reviewing personal legal documents and preparing promissory notes, affidavits and demand letters.
This benefit is limited to one use per year.
VSC_LP_C1_CS_M_370-2 (202103)
Warranty Dispute:
Review of the warranty policy or service contract where the attorney will:
(a) verbally explain the meaning or impact of any form or document or
(b) make suggestions for changes to a form or document being drafted
up to the maximum number of pages shown on the Schedule.
This benefit does not include:
(a) a written analysis or
(b) explanation of any form or document.
In the event of a dispute over the terms of the agreement between the warranty company and You, this benefit provides representation in a dispute relating to the warranty or service contract only if You have been sued or named in a small claims court action.
This service covers:
(a) counseling on prosecuting a small claims court action;
(b) helping You prepare documents;
(c) advising on evidence, documentation and witnesses; and
(d) preparing You for trial.
The service does not include:
(a) the attorney’s attendance or representation at a small claims trial,
(b) collection activities after a judgment or
any services relating to post-judgment actions.
This benefit is limited to one use per year.
VSC_LP_C1_CS_M_368-4 (202103)
Health Care Coverage Dispute and Records:
Up to the maximum as shown in the Schedule for office consultations with an attorney on any Health Care Coverage dispute, civil, involving a:
(a) coverage,
(b) benefits, or
(c) 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 You understand:
(a) health care law provisions and coverages based on the federal and/or state version of this law, and
(b) 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
(a) collection defense or
(b) other actions
related to medical bills or payments.
This benefit also includes:
(a) the review of simple health care policy coverage documents and
(b) the attorney will verbally explain the meaning or impact of any policy or related document or
(c) make suggestions for dispute letters or documents being drafted, of up to the maximum number of pages as shown in the Schedule.
This benefit does not include: a written analysis or explanation of any form or document.
This benefit does include the preparation of any of the following documents, up to the maximum number of pages shown on the Schedule:
(a) policyholder dispute correspondence, and
(b) simple affidavit.
Partial documents cannot be reviewed or prepared, and if the document is more than the maximum number of pages shown in the Schedule, the benefit does not apply.
Nothing in this benefit will pay or create any obligation to pay any health care or health insurance benefits to any person for any reason. Any coverage related to this benefit must be related to Your dispute under a health care or health insurance policy.
This benefit is limited to one use per year.
VSC_LP_C1_CS_M_369-3 (202103)
Identity Theft Defense:
Services related to Your representation regarding potential creditor actions resulting from identity theft, and attorney services as needed to contact:
(a) creditors,
(b) credit bureaus and
(c) financial institutions.
It also provides defense services for specific creditor actions over disputed accounts.
This benefit is limited to one use per year.
VSC_LP_C1_CS_M_395-2 (202103)
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. For a definition of Complex Wills, please see the Definitions section.
This benefit is limited to one use per year per Member/Covered Family Member.
VSC_LP_C1_CS_M_400-2 (202103)
Complex Will Preparation:
Attorney shall prepare a Complex Will or codicil.
This benefit shall be limited to one Complex Will prepared per year per Member/Covered Spouse/Covered Family Member.
VSC_LP_C1_CS_M_430-2 (202103)
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:
(a) Living Will
(b) Health Care Directive
(c) Advance Directive
(d) Health Care Power of Attorney
(e) Medical Power of Attorney
The titles of the above documents may vary by state. When state law allows the information contained in any two or more of the above mentioned documents to be combined into one document, then the benefit covers the preparation of only one document and cannot be combined to increase the total allowed benefit.
This benefit is limited to one use per year.
VSC_LP_C1_CS_M_440/450-4 (202103)
Revocable or Irrevocable Living Trust Document:
Preparation of a revocable or irrevocable living trust for You and/or Covered Family Member. 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.
VSC_LP_C1_CS_M_460 (202103)
Funeral Directive:
Preparation of a funeral directive for the Member/Covered Family Member.
This benefit is limited to one use per year.
VSC_LP_C1_CS_M_465-2 (202103)
Hospital Visitation Authorization:
Preparation of a hospital visitation authorization for Member/Covered Family Member.
This benefit is limited to one use per year.
VSC_LP_C1_CS_M_466-2 (202103)
Probate of Small Estate:
The service of an attorney for the probate of a small estate up to the maximum as shown in the Schedule. The estate must not be subject to current state or federal estate taxation.
VSC_LP_C1_CS_M_470 (202103)
Medicare/Medicaid/Social Security Proceeding:
This benefit will cover review or help with preparation of documents prior Your and/or Covered Family Member representation in any federal or state:
(a) Medicare,
(b) Medicaid or
(c) Social Security
administrative proceeding (including matters related to Your or Covered Spouse’s elder parent(s)), provided the elder parent’s interest is not in conflict with Your/Covered Spouse’s interest.
This benefit does cover:
(a) any matter that falls outside the jurisdiction of the Office of Medicare Hearings and Appeals,
(b) state office assigned to oversee Medicaid fair hearings, or
(c) Social Security administration.
This benefit applies to consultation or representation in a dispute relating to any such administrative proceeding and is covered up to the maximum shown in the Schedule. Consultation and/or preparation and assistance for any proceeding filed in court is also covered. You will be responsible for all fees incurred for representation needed after the maximum shown on the Schedule.
This benefit does not cover Your or the Covered Spouse’s elder parents if neither the You nor the Covered Spouse are named in any dispute, proceeding or litigation.
This benefit is limited to one use per year.
VSC_LP_C1_CS_M_480-2 (202103)
Social Security Administration Benefit Appeal:
Up to the maximum as shown in the Schedule for office consultations on any:
(a) appeal to the Social Security Administration of denied social security benefits or
(b) supplemental security income (SSI).
This benefit is designed to help prepare an appeal to any denials valued at more than $1,000.00 in social security benefits or SSI under the policy in dispute.
This benefit is not intended to provide:
(a) representation in litigation
(b) collection defense or
(c) other actions related to social security benefits or SSI.
This benefit also includes
(a) the review of simple Social Security Administration documents and
(b) verbal explanations of the meaning or impact of any policy or related documents, and
(c) suggestions for appeal letters or documents being drafted,
of up to the maximum number of pages as shown in the Schedule.
This benefit does not include a written analysis or explanation of any form or document and the preparation of any of the following documents, up to the maximum number of pages shown on the Schedule:
(a) appeal correspondence and
(b) simple affidavit.
Partial documents cannot be reviewed or prepared, and if the document other than the actual decision document from the Social Security Administration is more than the maximum number of pages shown in the Schedule, the benefit does not apply.
Nothing in this benefit will pay or create any obligation to pay any social security benefits or SSI to any person for any reason. Any coverage related to this benefit must be related to an appeal of a denial of social security benefits.
This benefit is limited to one use per year.
VSC_LP_C1_CS_M_481-4 (202103)
Veterans Benefits Appeal:
This benefit includes legal services for You in an administrative proceeding or appeal for denied Veterans benefits.
This benefit is limited to one use per year.
VSC_LP_C1_CS_M_482-2 (202103)
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. For a definition of Complex Wills, please see the Definitions section.
This benefit is limited to one use per year per Eligible Parent.
VSC_LP_C1_CS_M_401-2 (202103)
Elder Parent Living Will/Health Care or Advance Directive:
Each Eligible Parent may request one Living Will/Health Care or Advance Directive per year at no charge. For a definition of Living Will/Health Care or Advance Directive, please see the Definitions section. 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. When state law allows the information contained in any two or more of these documents to be combined into one document, then the benefit covers the preparation of both documents, and can be combined to increase the total allowed benefit.
This benefit is limited to one document/set of documents per year per Eligible Parent.
VSC_LP_C1_CS_M_441-2 (202103)
Elder Parent Durable Financial Power of Attorney:
Each Eligible Parent may request one Durable Financial Power of Attorney per year at the co-pay rate shown in the Schedule. For a definition of Durable Financial Power of Attorney, please see the Definitions section. The attorney will prepare the documents 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.
This benefit is limited to one use per year.
VSC_LP_C1_CS_M_311-4 (202103)
Elder Parent Health Care or Medical Power of Attorney:
Each Eligible Parent may request one Health Care or Medical Power of Attorney per year at the co-pay rate shown in the Schedule. For a definition of Health Care or Medical Power of Attorney, please see the Definitions section. The attorney will prepare the documents 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. When state law allows the information contained in any two or more these documents to be combined into one document, then the benefit covers the preparation of only one document and can not be combined to increase the total allowed benefit.
This benefit is limited to one use per year.
VSC_LP_C1_CS_M_451-4 (202103)
Elder Law Matters:
This service covers counseling You:
(a) over the phone or
(b) in the office
on any personal issues relating to the Eligible Parents as they affect You. This benefit includes reviewing documents of the Eligible Parents to advise You of the legal effect on You. The documents include:
(a) Medicare or Medicaid materials,
(b) prescription plans,
(c) leases,
(d) nursing home agreements,
(e) powers of attorney,
(f) living wills and
(g) wills.
The benefit also includes preparing deeds involving the Eligible Parents when You and/or Covered Spouse is either:
(a) the grantor or grantee; and
(b) preparing promissory notes involving the parents
when You and/or Covered Spouse is either the payor or payee.
This benefit is limited to one use per year.
VSC_LP_C1_CS_M_490-2 (202103)
Residential Matters
Real Estate Sale, Purchase or Refinancing of Primary Residence:
The services of an attorney for the sale, or purchase or refinancing of a primary residence (where You have resided or intends to reside for twenty-seven (27) weeks or more per year).
This service includes:
(a) the review and/or preparation of closing documents and/or
(b) attendance by the attorney at closing in situations when it is customary for the attorney to do so.
This benefit does not include:
(a) services performed by or for a title company, or
(b) 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.
This benefit does not include any fees or costs other than those related to the attorney’s review of the purchase/sale documents.
This benefit is limited to one closing per year.
VSC_LP_C1_CS_M_500/530/550-4 (202103)
First-time Home Buyer:
The services of an attorney for the purchase of a first primary residence (where You have resided or intends to reside for twenty-seven (27) weeks or more per year).
This service includes:
(a) the review and/or preparation of closing documents and/or
(b) attendance by the attorney at closing in situations when it is customary for the attorney to do so.
This benefit does not include:
(a) services performed by or for a title company, or
(b) for an attorney acting on behalf of a lending institution.
Home equity loans and the purchase of unimproved or rental properties are not included.
This benefit does not include any fees or costs other than those related to the attorney’s review of the purchase/sale documents.
This benefit is limited to one use per year and must be Your first home purchase.
VSC_LP_C1_CS_M_505-3 (202103)
Vacation or Investment Home Purchase, Sale or Refinancing:
The services of an attorney for the:
(a) purchase,
(b) sale, or
(c) refinancing
of a vacation or investment residence (where You have not resided or do not intend to reside for twenty-seven (27) weeks or more per year).
This service includes:
(a) the review and/or preparation of closing documents and/or
(b) attendance by the attorney at closing in situations when it is customary for the attorney to do so.
This benefit does not include:
(a) services performed by or for a title company, or
(b) for an attorney acting on behalf of a lending institution.
Home equity loans and the sale or purchase of unimproved properties are not included.
This benefit does not include any fees or costs other than those related to the attorney’s review of the purchase/sale documents.
This benefit is limited to one closing per year.
VSC_LP_C1_CS_M_515-2 (202103)
Home Equity Loan Assistance for Primary Residence, or Second or Vacation Home:
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:
(a) services performed by or for a title company, or
(b) for an attorney acting on behalf of a lending institution.
This benefit is limited to one closing per year.
VSC_LP_C1_CS_M_525-2 (202103)
Property Tax Assessment:
The services of an attorney for review and advice on a property tax assessment on a primary residence (where You have resided or intends to reside for twenty-seven (27) weeks or more per year). This benefit includes:
(a) filing the paperwork,
(b) gathering the evidence,
(c) negotiating a settlement, and
(d) attending the hearing necessary to seek a reduction of the assessment.
This benefit is limited to one use per year.
VSC_LP_C1_CS_M_570-2 (202103)
Property Tax Dispute:
Representation of You in a dispute involving property taxes on Your primary residence (where You have resided or intends to reside for twenty-seven (27) weeks or more per year).
This benefit does not include:
(a) the services of an attorney for review and advice on a property tax assessment or
(b) any other service covered under the Property Tax Assessment benefit.
This benefit is limited to one use per year.
VSC_LP_C1_CS_M_571-2 (202103)
Tenant Dispute:
Representation of You as a tenant in a dispute with Your landlord. This benefit does not include:
(a) representation for a tenant in a dispute with other tenants or
(b) for a tenant acting in his/her capacity as sublessee or sublessor.
This benefit is limited to one use per year.
VSC_LP_C1_CS_M_560-4 (202103)
Tenant Security Deposit Dispute:
The services of an attorney to assist You as a tenant in:
(a) recovering a security deposit from the residential landlord for the primary residence;
(b) reviewing the lease and other relevant documents; and
(c) preparing a demand letter to the landlord for the return of the deposit.
This benefit covers:
(a) preparation for prosecuting a small claims action;
(b) helping prepare documents;
(c) advising on evidence,
(d) documentation and witnesses; and
(e) preparing the Member for the small claims trial.
The service does not include:
(a) the attorney’s attendance or representation at the small claims trial,
(b) collection activities after a judgment or
(c) any services relating to post-judgment actions.
This benefit is limited to one use per year.
VSC_LP_C1_CS_M_565-2 (202103)
Landlord Dispute with Tenant:
This benefit covers You where You are a landlord, but where Your regular business or livelihood is that other than a landlord, for matters involving:
(a) evictions,
(b) leases, or
(c) disputes
with a residential tenant.
The service includes advice and representation if a lawsuit is filed up to the maximum shown on the Schedule.
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. You will be responsible for paying all fees for any additional services required.
This benefit is limited to one use per year.
VSC_LP_C1_CS_M_580-4 (202103)
Security Deposit Dispute with Tenant:
This benefit covers You where You are a landlord, but where Your regular business or livelihood is that other than a landlord, in:
(a) defending against the recovery of a security deposit from Your residential tenant for any residence owned and leased by You;
(b) reviewing the lease and other relevant documents; and
(c) preparing a letter to the tenant specifying what part of the deposit, if any, will not be returned.
It also covers:
(a)assisting You in defending a small claims action;
(b) helping prepare documents;
(c) advising on evidence, documentation and witnesses; and
(d) preparing You for the small claims trial.
The service does not include:
(a) the attorney’s attendance or representation at the small claims trial,
(b) collection activities after a judgment or
(c) any services relating to post-judgment actions.
This benefit is limited to one use per year.
VSC_LP_C1_CS_M_581-3 (202103)
Construction Defect Dispute:
The services of an attorney in a dispute relating to a defect or damage caused by the construction of Your new primary residence (where You have 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.
This benefit is limited to one use per year.
VSC_LP_C1_CS_M_591-2 (202103)
Neighbor Dispute:
The services of an attorney in a dispute relating to Your Neighbor up to the maximum shown in the Schedule. 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.
This benefit does not include matters involving:
(a) a dispute with a condominium/homeowners’/property owners association or
(b) a housing cooperative board, or
(c) any individual in his/her capacity as a member of a condominium/homeowners’/property owners’ association or
(d) a housing cooperative board.
This benefit is limited to one use per year.
VSC_LP_C1_CS_M_592-2 (202103)
Noise Reduction Dispute:
The services of an attorney in a dispute relating to Your enjoyment of Your residence, where any activity related to noise affecting Your enjoyment of Your home is prohibited by:
(a) federal,
(b) state or
(c) local law,
up to the maximum shown in the Schedule. Advice and/or preparation and assistance for a dispute filed in court is also covered, although representation in small claims court is not covered.
This benefit is limited to one use per year.
VSC_LP_C1_CS_M_593-2 (202103)
Boundary or Title Dispute:
Services needed to negotiate and/or litigate matters arising from boundary or Real Property title disputes involving:
(a) Your primary residence and
(b) where coverage is not available under Your 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.
This benefit is limited to one use per year.
VSC_LP_C1_CS_M_594-3 (202103)
Zoning Application:
Services needed to negotiate and/or litigate the change of zoning or variance for Your primary residence. This benefit applies to You as a named plaintiff or defendant.
This benefit includes:
(a) research and review of the law,
(b) surveys,
(c) advising the Member,
(d) preparing applications, and
(e) preparing for and attending the hearing.
This benefit does not include zoning or variance issues related to business assets or property.
This benefit is limited to one use per year.
VSC_LP_C1_CS_M_595-4 (202103)
Real Estate Dispute:
Services related to Your representation as a plaintiff or defendant in a dispute regarding contracts or obligations for the:
(a) construction,
(b) purchase, or
(c) sale
of Your primary residence (where You have resided or intends to reside for twenty-seven (27) weeks or more per year).
This benefit does not include disputes regarding contracts or obligations for the:
(a) purchase or
(b) sale of unimproved land.
This benefit does not include:
(a) the review or preparation of real estate construction contracts or closing documents, or
(b) attendance by the Member’s attorney at closing.
This benefit is limited to one use per year.
VSC_LP_C1_CS_M_596-2 (202103)
Private Real Estate Organization HOA/COA/POA or Co-Op Board Dispute Defense:
Services related to Your representation in a dispute involving a private real estate organization. This benefit includes Your representation in a dispute with a HOA/COA/POA or Co-Op board.
This benefit does not include disputes in which You and/or Covered Family Member:
(a) holds any position within the private real estate organization or
(b) holds a position as board member of the private real estate organization.
This benefit is limited to one use per year.
VSC_LP_C1_CS_M_597-2 (202103)
Financial Matters
Debt Collection Defense:
The defense of any dispute involving personal (non-business related) debt.
This benefit includes:
(a) correspondence,
(b) negotiating with creditors to arrange a repayment schedule,
(c) assistance in limiting harassment by bill collectors, and
(d) negotiating settlement after a complaint is filed.
This service does not include:
(a) defense against execution of a court-ordered judgment or
(b) efforts to vacate or set aside a judgment.
This benefit is limited to one use per year.
VSC_LP_C1_CS_M_600/620-2 (202103)
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:
(a) correspondence,
(b) negotiating with the court or opposing party to arrange a repayment schedule,
(c) assistance in limiting harassment by bill collectors,
(d) negotiating settlement after a complaint is filed, and
(e) representation at trial, if necessary.
This service does not include efforts to vacate or set aside a judgment.
This service does not include:
(a) counter, cross or third-party claims;
(b) bankruptcy;
(c) any action arising out of family law matters, including support and post-decree matters; or
(d) any matter where the creditor is affiliated with the Policyholder.
This benefit is limited to one use per year.
VSC_LP_C1_CS_M_621-2 (202103)
Bankruptcy:
Representation on Your behalf for personal bankruptcy protection under Chapter 7 or 13 of the Internal Revenue Code. This benefit does not include business related bankruptcy.
This benefit is limited to one use per year.
This benefit applies to the Member/Covered Spouse only.
VSC_LP_C1_CS_M_630-3 (202103)
Foreclosure:
Defense of You in an action to foreclose on Your primary residence (where You have resided or intends to reside twenty-seven (27) weeks or more per year.)
This benefit is limited to one use per year.
VSC_LP_C1_CS_M_640-2 (202103)
Tax Audit:
This benefit includes:
(a) the services of an attorney (but not accounting services) during a personal (non-business related) tax audit required by federal and
(b) state tax authorities and negotiations relating to it.
This benefit does not include a defense against criminal charges nor the defense of civil tax litigation in any tax court.
This benefit is limited to one use per year.
VSC_LP_C1_CS_M_650-2 (202103)
Tax Defense:
The defense of any dispute involving the collection of personal (non-business related) debt by a federal tax agency.
This benefit includes:
(a) correspondence,
(b) negotiating with the creditor tax agency to arrange a repayment schedule,
(c) assistance in limiting harassment by bill collectors,
(d) negotiating settlement after a complaint is filed, and
(e) representation at trial, if necessary.
This service does not include:
(a) defense against execution of a court-ordered judgment or
(b) efforts to vacate or set aside a judgment.
This service does not include:
(a) counter, cross or third-party claims;
(b) bankruptcy;
(c) any action arising out of family law matters, including support and post-decree matters; or
(d) any matter where the creditor is affiliated with the Policyholder.
This benefit is limited to one use per year.
VSC_LP_C1_CS_M_651-3 (202103)
Student Loan Refinancing/Collection Defense:
The services of an attorney up to the maximum shown in the Schedule for a student loan refinancing or collection dispute proceeding.
This benefit includes:
(a) negotiation with creditors for a repayment schedule and to limit creditor harassment,
(b) and representation in defense of any action for:
(1) personal debt collection,
(2) tax agency debt collection,
(3) foreclosure,
(4) repossession or
(5) garnishment,
all related to one or more school loans up to and including trial if necessary.
This benefit does not include:
(a) vacating a judgment;
(b) counter, cross or third-party claims;
(c) bankruptcy, any action arising out of family law matters, including support and post decree issues; or
(d) any matter where the creditor is affiliated with the sponsor or employer.
This benefit is limited to one use per year. This service covers the Member only, not a Covered Family Member, when there is an issue regarding a student loan in the name of the Member.
VSC_LP_C1_CS_M_625-3 (202103)
Repossession Defense:
The defense of any dispute involving the repossession of personal (non-business related) property by a private (non-governmental) party.
This benefit includes:
(a) correspondence,
(b) negotiating with the opposing party to arrange a repayment schedule,
(c) assistance in limiting harassment by bill or property repossession collectors,
(d) negotiating settlement after a complaint is filed, and
(e)representation at trial, if necessary.
This service does not include:
(a) defense against execution of a court-ordered judgment or
(b) efforts to vacate or set aside a judgment.
This service does not include:
(a) counter, cross or third-party claims;
(b) bankruptcy;
(c) any action arising out of family law matters, including support and post-decree matters; or
(d) any matter where the creditor is affiliated with the Policyholder.
This benefit is limited to one use per year.
VSC_LP_C1_CS_M_660-2 (202103)
Family Matters
Separation, Divorce, Civil Annulment:
Legal representation of You for up to the maximum shown on the Schedule 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:
(a) services in excess of the maximum shown on the Schedule, You must pay the attorney’s fee for services in excess of the maximum;
(b) 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; or
(c) services relative to post-decree representation.
A contested separation, divorce or civil annulment requires:
(a) more than five hours of attorney time and
(b) involves disputed issues and
(c) requires that both parties be represented by an attorney.
This benefit is limited to one use per year (representation seeking or defending against interim order shall constitute a separate use).
This benefit applies to the Member and Covered Family Members only for actions not involving the Member as an opposing party.
VSC_LP_C1_CS_M_710/720/730-4 (202103)
Post-Divorce Proceedings:
Legal representation of You for up to the maximum listed on the Schedule 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:
(a) services in excess of the maximum listed on the Schedule; You must pay the attorney’s fee for services in excess of the maximum;
(b) contested matters in which case You must pay the attorney’s fee for services, unless the coverage includes contested matters and the benefit shall be in accordance with the Schedule.
A contested post-divorce proceeding requires:
(a) more than five hours of attorney time,
(b) involves disputed issues and
(c) requires that both parties be represented by an attorney.
This benefit includes custody, support, and alimony proceedings.
This benefit is limited to one use per year.
This benefit applies to the Member only.
VSC_LP_C1_CS_M_733-3 (202103)
Domestic Partnership Agreement:
The service covers the preparation of a domestic partnership agreement by You and Your partner. Representation is provided only to You. The spouse/partner must have separate counsel or must waive representation.
This benefit is limited to one use per year.
VSC_LP_C1_CS_M_735-2 (202103)
Prenuptial Agreement:
This service covers the preparation of an agreement by You and Your fiancé/partner prior to Your marriage or legal union (where allowed by law), outlining how property is to be divided in the event of:
(a) separation,
(b) divorce or
(c) death of a spouse.
Representation is provided only to You. The fiancé/partner must have separate counsel or must waive representation.
This benefit is limited to one use per year.
This benefit applies to the Member only.
VSC_LP_C1_CS_M_705-3 (202103)
Gender Identifier Change:
Services required to change the gender identifier on government issued documents.
This benefit is limited to one use per year.
VSC_LP_C1_CS_M_742-2 (202103)
Egg/Sperm/Embryo Donation Agreement:
This service covers the preparation of an egg, sperm or embryo donation agreement for You.
This benefit is limited to one use per year.
VSC_LP_C1_CS_M_743-2 (202103)
Name Change:
Services required to accomplish a legal name change for You/Covered Family Member.
This benefit is limited to one use per year per Member/Covered Family Member.
VSC_LP_C1_CS_M_740-2 (202103)
Guardianship/Conservatorship:
Services required to establish You/Covered Family Member as the guardian(s) or conservator(s) of a family member of either You or Covered Spouse. This benefit does not include fees for a court-appointed attorney for the child/conservatee.
This benefit is limited to one use per year.
VSC_LP_C1_CS_M_750-3 (202103)
Government Agency/Stepparent Adoption:
Legal representation up to the maximum shown in the Schedule in a:
(a) governmental agency or
(b) stepparent adoption.
An uncontested adoption does not involve significant disputed issues.
This benefit does not include:
(a) contested termination of parental rights;
(b) fees for a court-appointed attorney for the child; or
(c) adoptions(s) made through any agency other than a governmental agency.
A contested adoption requires:
(a) more than five hours of attorney time and
(b) involves disputed issues.
This benefit is limited to one use per year.
VSC_LP_C1_CS_M_760/770-2 (202103)
Child Custody/Support Proceeding Involving Never-Married Parents:
Legal representation up to the maximum shown in the Schedule in a child custody/support proceeding. This service covers You and/or Covered Family Member, when there is an issue of child custody/support of a child parented by a person with You/Covered Family Member, but never married to You/Covered Family Member.
This service covers:
(a) representation to obtain a support order, including all required paperwork and
(b) attendance at all court appearances.
The service does not include:
(a) representation in suits for damages,
(b) defense of any action,
(c) representation for the opposing parent, or
(d) any paternity proceeding.
If the amount of an attorney’s time for an uncontested or contested child custody/support proceeding exceeds the maximum shown in the Schedule, then coverage will terminate and You will be responsible for any additional legal fees.
This benefit is limited to one use per year.
VSC_LP_C1_CS_M_731-2 (202103)
Paternity Proceeding:
Legal representation up to the maximum shown in the Schedule in a paternity proceeding, whether You are bringing or defending this action.
This service covers:
(a) representation to obtain a court order, including all required paperwork and
(b) attendance at all court appearances.
The service does not include:
(a) representation in suits for damages,
(b) defense of any action, or
(c) representation for the opposing parent. If the amount of an attorney’s time for an uncontested or contested paternity proceeding exceeds the maximum shown in the Schedule, then coverage will terminate, and You will be responsible for any additional legal fees.
This benefit is limited to one use per year.
VSC_LP_C1_CS_M_732-2 (202103)
Stalking Victim Assistance:
This benefit covers:
(a) advice and consultation,
(b) preparation of affidavits and any temporary restraining order (TRO), and
(c) review of any related documents for any who is a victim of a stalking incident(s) as defined by state law.
This benefit also covers services needed to help the victim prepare for hearings. This benefit does not include representation for a Covered Family Member when it conflicts with Your interests.
This benefit is limited to one use per year.
VSC_LP_C1_CS_M_745-2 (202103)
Protection from Domestic Violence:
Services needed to assist You only, in obtaining a protective order arising from a domestic violence or abuse matter, including:
(a) all required paperwork and
(b) attendance at all court appearances.
This benefit does not include:
(a) representation in suits for damages,
(b) defense of any action, or
(c) representation of the offender.
This benefit is limited to one use per year.
This benefit applies to the Member only.
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Juvenile Court Proceeding:
Services related to the representation of Your/Covered Family Member’s dependent child in any juvenile court proceeding, provided the child’s interest is not in conflict with the Your and/or Covered Family Member’s interest. This benefit does not cover any matter that falls outside the jurisdiction of juvenile court or any matter that may be considered a felony.
This benefit is limited to one use per year.
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School Administrative Proceeding:
Services needed for Your/Covered Family Member’s dependent child for:
(a) consultations, and
(b) 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 Your 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.
This benefit is limited to one use per year.
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Immigration Assistance:
This service covers:
(a) advice and consultation,
(b) preparation of affidavits and powers of attorney,
(c) review of any immigration documents, and
(d) helping You prepare for hearings.
This service also covers representation in the defense or assertion of status relating to immigration policies. This benefit also extends to Your Covered Family Members and non-covered family members, including Your parent 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.
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Parental Responsibility Matters:
Representation of You/Covered Spouse in juvenile court proceedings (except those involving traffic matters) where the State has brought an action against You/Covered Spouse relating to Your parental responsibilities for a Covered Family Member.
This benefit is limited to one use per year.
This benefit applies to the Member/Covered Spouse only.
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Civil Matters
Civil Litigation Defense:
Services related to representation when You are named as defendant in a filed civil lawsuit (non-business related), up to and including the trial thereof. This benefit does not include: (a) any debt collection or family law matters; (b) lawsuits normally handled on a contingent fee basis; or (c) matters for which You have or are required by law to have insurance.
This benefit is limited to one use per year.
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Incompetency Defense:
Services related to Your representation in the defense of any incompetency action, including court hearings when there is a proceeding to find You incompetent.
This benefit is limited to one use per year.
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Administrative Hearing Representation:
Services needed to defend You from civil proceedings before a:
(a) municipal,
(b) county,
(c) state, or
(d) federal
administrative board, agency or commission.
It includes the hearing before an administrative board or agency regarding an adverse governmental action. It does not apply where services are available or are being provided by virtue of an insurance policy. It does not include family law matters, post judgment matters or litigation of a job-related incident.
This benefit is limited to one use per year.
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Discounted Contingency Fees:
Participating Attorneys will handle the matter at a maximum percentage of the gross award. It is Your responsibility to pay this fee and all costs.
(a) When state laws set contingency fees: Lesser of 10 % less than state law maximum fee or the Participating Attorney’s usual fee.
(b) 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.
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Mediation:
The services of an attorney for representation at a mediation. This benefit does not include the cost of the mediator’s services.
This benefit is limited to one use per year.
This benefit applies to the Member only.
VSC_LP_C1_CS_M_850-2 (202103)
Traffic and Administrative Matters
Traffic Ticket:
Services related to representing You in defense of any traffic ticket except driving under influence or vehicular homicide, including:
(a) court hearings,
(b) negotiation with the prosecutor,
(c) trial, and
(d) counseling and preparing You for self-representation at any hearings if chosen.
This benefit does not cover violations related to a commercial driver’s license. This benefit does not apply to Driving Under the Influence (DUI) or Driving While Intoxicated (DWI) violations/citations.
This benefit is limited to one use per year.
VSC_LP_C1_CS_M_810-3 (202103)
Serious Traffic Matter:
Services related to representing You when You are:
(a) charged by governing authorities with moving traffic violation(s) and
(b) conviction could result in suspension or revocation of a state-issued license permitting a person to drive a motor vehicle.
This benefit does cover violations related to a commercial driver’s license. This benefit does not apply to Driving Under the Influence (DUI) or Driving While Intoxicated (DWI) violations/citations. This benefit can not include expungements of misdemeanor convictions. This benefit does not include adjustments to probation or parole.
This benefit is limited to one use per year.
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Administrative Proceeding:
Services related to representing You in an administrative proceeding relating to the:
(a) suspension or
(b) revocation
of driving privileges.
This benefit does not cover suspension or revocation of a commercial driver’s license.
This benefit is limited to one use per year.
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Habeas Corpus Proceeding:
Services related to the representation in a Habeas Corpus proceeding.
This benefit is limited to one use per year.
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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
- 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).
- 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.
- Review of necessary recovery legal documents (up to 6 pages each).
OBTAINING BENEFITS
Claim for Benefits
You should call the Member Service Center to confirm the potentially applicable benefit(s) prior to consulting with any attorney. You/Covered Family Member must provide all information requested with respect to the circumstances of an insured event or service provided. The Member Service Center will assign a Participating Attorney to provide services relative to the matter. Failure to notify the Member Service Center within thirty (30) days following consultation with an attorney may result in a denial of benefits, if such failure to provide timely notice has prejudiced Us in any way. Failure to provide notice within thirty (30) days will not invalidate or reduce an otherwise valid claim if it is shown not to be reasonably possible to give such notice within 30 days and that notice was given as soon as reasonably possible thereafter. Coverage applies to covered events which occur while the coverage is in effect. Any covered event which occurs prior to the effective date of coverage will be considered excluded and no benefits will apply.
You may reach the Member Service Center at:
5151 San Felipe, Suite 2300
Houston, TX 77056
888-416-4313
Disputes Between Member and Covered Family Member
In the event that Your and one of the Covered Family Members are involved as adversaries in a dispute that is a Covered Service, only You 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.
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EXCLUSIONS
The following benefits are excluded:
(a) Appellate court proceedings.
(b) Class actions.
(c) Interventions.
(d) Malpractice proceedings.
(e) Actions in which punitive damages are being sought.
(f) Derivative actions and amicus curiae filings.
(g) The preparation and filing of:
(1) individual, partnership or estate tax returns,
(2) appellate or administrative proceedings related to tax returns,
(3) 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.
(h) Legal services that are fully paid for or provided at no cost by any governmental agency, organization or insurance company.
(i) 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.
(j) Costs associated with covered legal services. This includes, but not limited to, the following:
all fines, court costs, penalties, sanctions, expert witness fees, bonds, bail bonds, attorney fees awarded as part of a judgment, exhibits, deposition costs, filing fees, transcripts, postage, telephone, photocopying, recording fees, messengers, judgments, jury fees, court reporter fees, investigative costs, mediator or arbitrator fees. This also includes all other incidental and out-of-pocket legal and litigation costs.
(k) Any services on behalf of a Covered Family Member against Your interests.
(l) Any dispute or proceeding against the following persons or entities, their officers, directors, employees, or agents:
(1) any person or entity involved in the sale, marketing, administration or other processes related to the Policy;
(2) Legal Plan Administrator or its subsidiaries;
(3) Claims Administrator or its subsidiaries;
(4) Policyholder;
(5) Your employer;
(6) Virginia Surety Company, Inc. and it’s parents, subsidiaries or any affiliated or successor company, plan underwriter or reinsurer;
(7) Plan Sponsor; or any Participating and/or Non-Participating Attorney
if the dispute or proceeding pertains to services provided under the Policy.
(m) The Policy does not allow benefits listed under the Covered Services section to be combined for one legal matter.
(n) Where there are specific hours or dollar amounts provided in the Policy, or where a maximum is set under the Managed Case Rules, You will be responsible for all attorney fees incurred which exceed the maximum. Additional exclusions related to each benefit are included in the Covered Services.
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(o) Matters relating to: securities, trademark or patent matters; business or commercial interests, including, but not limited to the following:
(1) professional, partnership and/or corporate matters;
(2) matters arising out of Your/Covered Family Member’s role as an officer or director of an organization;
(3) matters involving the law or laws of jurisdictions other than the United States and its territories and Canada, except as specifically described under Covered Services;
(4) any matters involving a government (domestic or foreign) entity or agency except as specifically described under Covered Services;
(5) farm related issues.
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(p) Any employment-related matter. This includes, but is not limited to the following:
(1) any dispute involving
- Your employer or its affiliates,
- their officers or directors,
- Your employee benefit plans,
- credit unions,
- programs or arrangements sponsored by an employer, or
(2) cases involving:
- workers’ compensation,
- unemployment compensation,
- sex harassment, and
- age discrimination.
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(q) Except for consultation, the Policy will not provide benefits in connection with pre-existing matters. Pre-existing matters include any matter where You/Covered Family Member are on notice:
(1) as to a pending legal dispute or
(2) has previously contacted an attorney except when prior coverage under another Legal Plan provided by the Policyholder can be demonstrated.
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(r) Any criminal misdemeanor or felony matter.
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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. You have the unrestricted right to choose an attorney. Your relationship with an attorney is privileged and strictly confidential. We will not interfere in:
(a) the attorney-client relationship or
(b) 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.
You shall authorize the Participating Attorney to provide the Legal Plan Administrator with:
(a) information and
(b) supporting documentation
on the number and type of services provided to You.
By using legal services benefits that are provided under the Policy, You agree that neither:
(a) We,
(b) the Policyholder,
(c) nor any other person
involved in the marketing or administration of the Policy, shall have any liability for the:
(a) acts,
(b) errors or omissions
of an attorney providing services, in whole or in part.
Non-Participating Attorney Services
If You already have an attorney, You may prefer to use her/him as a Non-Participating Attorney. To do so, You must first contact the Member Service Center and notify the representative of Your intention to use a Non-Participating Attorney for a Covered Service. The Member Service Center will send You a claim form which must be completed and returned in order to request reimbursement. Your reimbursement will be based on the reimbursement schedule shown under the Non-Participating Attorney column of the Schedule. If You have a Non-Participating Attorney You would prefer to work with, the Legal Plan Administrator may elect to offer to negotiate with the attorney on Your behalf but cannot guarantee the Non-Participating Attorney will accept the Plan Discounted Rate.
Subrogation and Coordination of Benefits
All benefits will be subject to subrogation and coordination of benefit rules. For the purpose of subrogation, We may require You/Covered Family Member to assign all rights of recovery of legal fees to the extent that payment is made by Us. If an assignment is sought, You/Covered Family Member must cooperate in providing the assignment.
The Policy coordinates benefits as follows: when a claim is made, the primary plan pays its regular benefit first. A plan is primary when it:
1. covers Policyholder’s employee as insured rather than as a dependent
2. covers a child as dependent of the parent whose birthday occurs earliest in the calendar year, except when:
(a) parents are separated or divorced and parent with custody is not remarried: benefit of parent with custody is primary
(b) parents are divorced and parent with custody is remarried, the order of determination is:
(i) parent with custody
(ii) step-parent
(iii) parent without custody
(c) a court decree establishes financial responsibility for a child’s legal expenses: then that parent’s plan is primary
If none of the above applies, the plan that has covered the insured the longest is primary, except if the insured is laid off or retired.
If You are entitled to receive legal services or reimbursement for legal services from any other person or organization, Our coverage will be excess.
Payment by Us for legal services under the Policy does not preclude Your attorney from seeking and recovering attorney fees from an opposing party, where authorized by law, court rule or contract, at the attorney’s usual and customary or prevailing rate. If You receive reimbursement of attorney’s fees, then You will reimburse Us for payments made under the Policy.
Legal Terminology
You or Covered Family Member may call the Member Service Center to obtain a definition or explanation of any term used herein.
Premium Refund Provision
In the event that:
(a) the premium mode is other than monthly and
(b) the Group Policy is terminated or
(c) You elect 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:
(a) Cancellation or termination of the Group Policy;
(b) If applicable, the Member fails to re-enroll;
(c) The Member is no longer associated with Policyholder; or
(d) The Member fails to remit premium when due, subject to the statutory grace period.
Coverage provided to a Covered Family Member of a Member shall terminate upon the first of the following to occur:
(a) The Member’s coverage is cancelled or terminated; or
(b) The family member ceases to qualify as a Covered Family Member as defined in the Definitions section.
Illegal Activity, Misrepresentation and Fraud
No misrepresentation shall avoid any contract of insurance or defeat recovery, thereunder, unless such misrepresentation was material. No misrepresentation shall be deemed material unless knowledge by the insurer of the facts misrepresented would have led to a refusal by the insurer to make such contract. We will not provide coverage if doing so would be in violation of any United States economic or trade sanction.
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.
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Coverage Territory
The coverage territory includes the United States and United States territories and Canada.
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Portability
You may continue this insurance by electing the option of portability when You no longer qualify as
(a) an employee of the Policyholder or
(b) as a Member of the group to which the Group Policy is issued.
You 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 Your coverage under the Group Policy terminates.
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Waiver of Premium
Upon Your death, 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 You being called to active duty for a period of more than thirty (30) consecutive days
(a) for the purposes of:
(b) military service or of responding to a declared national emergency coverage for the Covered Family Members will continue, without the payment of premium, for:
(a) the length of the Member’s absence and
(b) for so long as the Member remains eligible for benefits through the Policyholder.
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Grievances
Should You have a dispute concerning Your coverage, payment or about a reimbursement, You should first contact LegalEASE Member Service Center at 888-416-4313. If the dispute is not resolved, You may contact Virginia Surety Company at 1-800-209-6206.
Nothing in this plan shall be construed to prevent You from making a complaint to the appropriate Appellate Division or other body designated by the Appellate Division to investigate complaints in accordance with Judiciary Law section 90, or to the appropriate disciplinary body in the state where the legal service is being provided.
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Network
- 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
- 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.