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| Accident Expense Coverage for Members and their Families |
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| • Pays 100% of Covered Medical Expenses after satisfaction of the $100 or $250 Deductible up to the coverage maximum |
| • Use any doctor or hospital |
| • NEW CallMD, a network of medical doctors you can call for a consultation or medical needs anytime, any day! |
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| • Accidental Death & Dismemberment benefits |
| • Emergency Helicopter Air Ambulance benefits |
| • Automatic acceptance through age 69 |
| • Benefits are paid directly to you |
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Basic |
Basic Plus |
Basic Premier |
Premier |
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$2,500
(after a $100 deductible is satisfied) |
$5,000
(after a $100 deductible is satisfied) |
$7,500
(after a $250 deductible is satisfied) |
$10,000
(after a $250 deductible is satisfied) |
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$5,000 |
$5,000 |
$7,500 |
$10,000 |
| EMERGENCY HELICOPTER AIR AMBULANCE WORLDWIDE COVERAGE |
| More Info... |
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$4,000 |
$4,000 |
$4,000 |
$4,000 |
Monthly Cost Single or Family*
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$34.95
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$44.95
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$54.95
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$64.95 |
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| * Includes a $9.95 monthly administration fee. |
Accident Medical Expense benefits are excess to other coverage.
**Accident Death & Dismemberment benefit are at lower amounts than shown for spouse and dependents.
This site depicts only a summary of services provided. For complete details, including exceptions and limitations refer to Membership material. |
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| BENEFITS DETAILS |
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ACCIDENTAL DEATH, DISMEMBERMENT SCHEDULE
AND LOSS OF SIGHT, SPEECH AND HEARING BENEFIT |
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| Description of Loss |
Benefit Maximum |
| Life; Both Hands or Both Feet; Sight of Both Eyes; Speech and Hearing.............. |
Principal Sum |
| Either Hand, Foot, Sight of One Eye, Speech or Hearing.................................... |
One-Half the Principal Sum |
| Thumb and Index Finger of the Same Hand or Four Fingers of the Same Hand..... |
One-Quarter the Principal Sum |
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| See certificate of coverage for dependent benefit maximum |
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| ACCIDENT MEDICAL EXPENSE BENEFITS |
| The Carrier will pay Accident Medical Expense Benefits for Covered Expenses that result directly, and from no other cause, from a Covered Accident. These benefits are subject to the Deductible, Maximum Benefit Period, Benefit Maximum and other terms or limits shown below. |
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• Benefit Maximum: $2,500, $5,000, $7,500 or $10,000 (depending on the coverage amount purchased)
• Maximum Benefit Period: 365 days after the date of the Covered Accident
• Deductible: $100
• Accident Medical Expense Benefits are only payable:
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For Usual and Customary Charges incurred after the Deductible has been met; |
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For those Medically Necessary Covered Expenses that You receive; and |
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If the first incurred expenses are within 365 days from the date of the Covered Accident. No benefits will be paid for any expenses incurred that, in Our judgment, are in excess of Usual and Customary Charges. |
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| Covered Medical Expenses: |
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Hospital Room and Board Expenses: the daily room rate when You are Hospital Confined and general nursing care is provided and charged for by the Hospital. In computing the number of day’s payable under this benefit, the date of admission will be counted but not the date of discharge |
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Ancillary Hospital Expenses: services and supplies including operating room, laboratory tests, anesthesia and medicines (excluding take home drugs) when Hospital Confined. |
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Medical Emergency Care (room and supplies) for Expenses incurred within 72 hours of an Accident and including the attending Doctor’s charges, X-rays, laboratory procedures, use of the emergency room and supplies. |
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Outpatient Surgical Room and Supply Expenses for use of the surgical facility. 5) Outpatient diagnostic X-rays, laboratory procedures and tests. |
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Doctor Non-Surgical Treatment/Examination Expenses (excluding medicines) including the Doctor’s initial visit, each necessary follow-up visit and consultation visits when referred by the attending Doctor. |
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Doctor’s Surgical Expenses if an Injury requires multiple surgical procedures through the same incision, the Carrier will pay only one benefit, the largest of the procedures performed. If multiple surgical procedures are performed during the same operative session but through different incisions, the Carrier will pay for the most expensive procedure and 50% of covered expenses for the additional surgeries. |
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Assistant Surgeon Expenses when Medically Necessary. |
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Anesthesiologist Expenses for pre-operative screening and administration of anesthesia during a surgical procedure whether on an inpatient or outpatient basis. |
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Outpatient Laboratory Test Expenses. |
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Physiotherapy Expenses on an inpatient or outpatient basis limited to one visit per day; Expenses include treatment and office visits connected with such treatment when prescribed by a Doctor, including diathermy, ultrasonic, whirlpool, or heat treatments, adjustments, manipulation, massage or any form of physical therapy. |
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X-ray Expenses (including reading charges) but not for dental X-rays. |
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Diagnostic Imaging Expenses: including Magnetic Resonance Imaging (MRI) and CAT Scan. |
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Dental Expenses including dental x-rays for the repair or treatment of each injured tooth that is whole, sound and a natural tooth at the time of the Accident. |
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Ambulance Expenses for transportation from the emergency site to the Hospital. |
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Rehabilitative braces or appliances prescribed by a Doctor. It must be durable medical equipment that a) is primarily and customarily used to serve a medical purpose; b) can withstand repeated use; and c) generally is not useful to a person in the absence of Injury. No benefits will be paid for rental charges in excess of the purchase price. |
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Prescription Drug Expenses (for injuries only) prescribed by a Doctor and administered on an outpatient basis. |
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Medical Equipment Rental Expenses for a wheelchair or other medical equipment that has therapeutic value for You. The Carrier will not cover computers, motor vehicles or modifications to a motor vehicle, ramps and installation costs, eyeglasses and hearing aids. |
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Medical Services and Supplies: expenses for blood and blood transfusions; oxygen and its administration. |
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| Note: Covered Medical Expense is the Usual and Customary Charge based on the average amount charged by most providers for treatment, service or supplies in the geographic area where the service is provided. |
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Exposure and Disappearance: Coverage includes exposure to the elements after the forced landing, stranding, sinking, or wrecking of a vehicle in which the Covered Person was traveling.
A Covered Person is presumed dead if: |
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he or she is in a vehicle that disappears, sinks, or is stranded or wrecked on a trip covered by the Policy; and |
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the body is not found within one year of the Covered Accident. |
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| Accidental Death & Dismemberment Benefits: If the Covered Person’s Injury results in any of the following losses within 365 days after the date of the Covered Accident, the Carrier will pay the amount shown below for that loss. If multiple losses occur, only one Benefit Amount, the largest, will be paid for all losses due to the same Covered Accident. |
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| Principal Sum (amount is based on the coverage level purchased) |
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| Description of Loss Benefit Maximum |
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Life; Both Hands or Both Feet; Sight of Both Eyes; Speech and Hearing: Principal Sum |
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Either Hand, Foot, Sight of One Eye, Speech or Hearing: One-Half the Principal Sum |
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Thumb and Index Finger of the Same Hand or Four Fingers of the Same Hand: One-Quarter the Principal Sum |
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| “Member” means Loss of Hand or Foot, Loss of Sight, Loss of Speech, and Loss of Hearing. “Loss of Hand or Foot” means complete Severance through or above the wrist or ankle joint. “Loss of Sight” means the total, permanent Loss of Sight of one eye. “Loss of Speech” means total and permanent loss of audible communication that is irrecoverable by natural, surgical or artificial means. “Loss of Hearing” means total and permanent Loss of Hearing in both ears that is irrecoverable and cannot be corrected by any means. “Loss of a Thumb and Index Finger of the Same Hand” or “Loss of Four Fingers of the Same Hand” means complete Severance through or above the metacarpophalangeal joints of the same hand (the joints between the fingers and the hand). “Severance” means the complete and permanent separation and dismemberment of the part from the body. |
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Age Reduction Schedule:
The amount payable for a loss will be reduced to the following based on the covered person’s age on the date of the Covered Accident causing the loss:
65% of the Principal Sum if the Covered Person is aged 70-74
45% if the Covered Person is aged 75-79
30% if the Covered Person is aged 80-84
15% if the Covered Person is aged 85 and older.
If the Covered Person is age 70 or older, his or her premium is based on 100% of the coverage that would be in effect if he or she were under age 70. “Age” as used above refers to the Covered Person’s age on his or her most recent birthday.
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| VBA TERMS |
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| VBA TERMS AND CONDITIONS |
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1. Member understands that VBA is not an insurance company or program. Accident Benefit Payments are made by the administrator for the insurance company issuing the blanket coverage to Members.
2. VBA provides savings to its members on services through a number of sources. The current list of benefits may be modified through additions or deletions. A quarterly newsletter, posted on our website or sent via e-mail, will keep Members up to date on benefits and other pertinent information.
3. Payments for the VBA Program are due in advance. Payments will be drafted on or about 15 days before the due date. If you choose to cancel your program, it is your responsibility to make sure that your membership card and a written request for cancellation are sent to VBA at least 15 days prior to the anniversary of your effective date in order for your account not to be charged for additional fees.
4. Member hereby appoints, Value Benefits of America Association (VBA) President, or failing this person, a VBA Director, as proxy holder for and on behalf of the member with the power of substitution to attend, act and vote for and on behalf of the member in respect of all matters that may properly come before the meeting of the members of VBA and at every adjournment thereof, to the same extent and with the same powers as if the undersigned member were present at the said meeting, or any adjournment thereof. Annual meetings are to be held in Arizona the second Tuesday of August.
5. VBA reserves the right to terminate any enrollment or deny eligibility in the program for lack of payment to VBA. Returned checks, insufficient notices on bank drafts or denial by the member’s credit card company for payment of the membership fee is deemed to be evidence of non-payment by a member. There will be a $10.00 charge to be reinstated in the program after such denial. If reinstatement for non-payment happens more than once, a $20.00 reinstatement will apply.
6. In the event of any dispute, member agrees to resolve said dispute solely by binding arbitration that shall be governed by the laws of the state of Arizona and enforceable at Scottsdale, Maricopa County.
7.Membership cancelled within the first 30 days of the enrollment date may be eligible for refund if the membership card and written cancellation request are sent to VBA. The administrative fee is not refundable. Approved refunds will be processed approximately 30 days after cancellation.
8. Membership is effective on the 1st of the month following enrollment acceptance by VBA.
Member Agreement:
By signing your enrollment form, Member expresses desire to become a member of Value Benefits of America. Member acknowledges that the discount plans ARE NOT INSURANCE, but membership includes certain limited supplemental insured coverage's. Membership benefits are not a replacement for health insurance coverage nor are they intended as a substitute for health insurance coverage. Membership fees may change for all members, but not individually, with notification. |
| Discount Benefits Are Not Insurance |
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| DEFINITIONS |
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| IMPORTANT DEFINITIONS: |
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Active Service: means You are either 1) actively at work performing all regular duties on a full-time basis either at Your employer’s place of business or someplace the employer requires You to be; 2) employed, but on a scheduled holiday, vacation day or period of approved paid leave of absence; or 3) if not employed, able to engage in substantially all of the usual activities of a person in good health of like age and sex and not confined in a hospital or rehabilitation or rest facility.
Covered Accident: means an accident that occurs while coverage is in force for a Covered Person and results directly and independently of all other causes in a loss or Injury covered by the Policy for which benefits are payable.
“Covered Person” means any eligible person, including Dependents if eligible for coverage under the Policy, for whom the required premium is paid.
Dependent: means Your lawful spouse; or Your unmarried child, from the moment of birth to age 19, 25 if a full-time student, who is chiefly dependent on You for support. A child, for eligibility purposes, includes Your natural child; adopted child, beginning with any waiting period pending finalization of the child’s adoption; or a stepchild who resides with You or depends on You for financial support. A Dependent may also include any person related to You by
blood or marriage and for whom You are allowed a deduction under the Internal Revenue Code. Insurance will continue for any Dependent child who reaches the age limit and continues to meet the following conditions: 1) the child is handicapped, 2) is not capable of self-support and 3) depends mainly on You for support and maintenance. You must send Us satisfactory proof that the child meets these conditions, when requested. The Carrier will not ask for proof more than once a year.
Injury: means accidental bodily harm sustained by a Covered Person that results directly and independently from all other causes from a Covered Accident. The Injury must be caused solely through external, violent and accidental means. All injuries sustained by one person in any one Covered Accident, including all related conditions and recurrent symptoms of these injuries, are considered a single Injury.
Medically Necessary: means a treatment, service or supply that is: 1) required to treat an Injury; prescribed or ordered by a Doctor or furnished by a hospital; 2) performed in the least costly setting required by Your condition; and 3) consistent with the medical and surgical practices prevailing in the area for treatment of the condition at the time rendered. Purchasing or renting 1) air conditioners; 2) air purifiers; 3) motorized transportation equipment; 4) escalators or elevators in private homes; 5) eye glass frames or lenses; 6) hearing aids; 7) swimming pools or supplies for them; and 8) general exercise equipment are not Medically Necessary. A service or supply may not be Medically Necessary if a less intensive or more appropriate diagnostic or treatment alternative could have been used. The Carrier may, at their discretion, consider the cost of the alternative to be the Covered Expense.
Personal Deviation: means 1) an activity that is not reasonably related to Association of Healthy Ideas and Resources’ business; and 2) not incidental to the purpose of the trip.
Usual and Customary Charge: means the average amount charged by most providers for treatment, service or supplies in the geographic area where the treatment, service or supply is provided
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| Exclusions and Limitations |
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| The Carrier will not pay benefits for any loss or Injury that is caused by, or results from: |
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Intentionally self-inflicted Injury. |
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Suicide or at tempt ed suicide. |
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War or any act of war, whether declared or not (except as provided by the Policy). |
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A Covered Accident that occurs while on active duty service in the military, naval or air force of any country or international organization. Upon Our receipt of proof of service, the Carrier will refund any premium paid for this time. Reserve or National Guard active duty training is not excluded unless it extends beyond 31 days. |
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Sickness, disease, bodily or mental infirmity, bacterial or viral infection or medical or viral infection or medical or surgical treatment thereof, except for any bacterial infection resulting from an accidental external cut or wound or accidental ingestion of contaminated food. |
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Piloting or serving as a crewmember in any aircraft (except as provided by t he Policy). |
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Commission of, or attempt to commit, a felony, an assault or other criminal activity. |
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| In addition to the exclusions above, the Carrier will not pay Accident Medical Expense Benefits for any loss, treatment or services resulting from or contributed to by: |
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Treatment by persons employed or retained by a Policyholder, or by any Immediate Family or member of Your household. |
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Treatment of sickness, disease or infections except pyogenic infections or bacterial infections that result from the accidental ingestion of contaminated substances. |
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Treatment of hernia, Osgood-Schlatter’s Disease, osteochondritis, appendicitis, osteomyelitis, cardiac disease or conditions, pathological fractures, congenital weakness, hernia, detached retina unless caused by an Injury, or mental disorder or psychological or psychiatric care or treatment (except as provided in the Policy), whether or not caused by a Covered Accident. |
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Pregnancy, childbirth, miscarriage, abortion or any complications of any of these conditions. |
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Mental and Nervous Disorders (except as provided in the Policy). |
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Damage to or loss of dentures or bridges, or damage to existing orthodontic equipment (except as specifically covered by the Policy). |
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Expense incurred for treatment of temporomandibular or craniomandibular joint dysfunction and associated myofacial pain (except as provided by the Policy). |
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Injury covered by Workers’ Compensation, |
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| FAQ |
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| FREQUENTLY ASKED QUESTIONS |
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| When will my benefits become effective? |
| All effective dates are the 1st of the month following your enrollment. |
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| Do the accident expense benefits coordinate with other coverage? |
| Yes, the benefits are secondary to other coverage and will coordinate with other insurance. |
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| Do I have benefits outside of the United States? |
| Yes, if you are traveling for pleasure outside of the United States you will be eligible for benefits. |
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| What is the maximum age for accident benefits? |
| At age 70 the accident benefits are no longer available to VBA members. |
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| Are dependents eligible as members? |
| Yes, a spouse to age 69 and dependent children to age 19 or full time student under age 25. |
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| Is there a limit to the number of accidents per year that are covered? |
| No, the benefits are paid on a per accident occurrence. |
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| What are the payment options? |
| You may pay by monthly credit card or monthly automatic bank draft. |
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| What other benefits are available to me as a VBA member? |
| There are many valuable benefits as a VBA member that you will receive in your fulfillment packet or can preview on this web site. |
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| What if I have questions regarding the benefits after I enroll? |
| You can contact your agent or call our toll free customer service line. |
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| Security and Privacy Statement |
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When you become a GACquote.com customer, you entrust us with your personal data. We consider your data to be private and confidential, and we hold ourselves to the highest standards of trust and fiduciary duty in their safekeeping and use.
General Agent Center (GAC) and our partners will not release information about you or your application, policy or claims information, unless one or more of the following conditions are met:
- We receive your prior written consent.
- We believe the prospective recipient to be you or your authorized representative.
- We are required by law to release information to the recipient.
Questions about your medical history and physical condition are required by our insurance carrier partners and will be released to the insurer so that they may underwrite your insurance application. GAC will not give or sell information about you to any other company, individual, or group without your prior authorization.
GAC will only use information about you to help us better serve your insurance needs or to suggest GAC services or insurance materials that may be of interest to you.
To further protect your privacy, our web site uses the highest levels of Internet security, including data encryption, user names and passwords, and other security tools.
Occasionally, GAC may conduct marketing surveys or research to help us evaluate products, services, and the changing needs of our customers. It is GAC's policy to keep this information confidential.
We will not share individual marketing data gathered from our web site with individuals or business entities not affiliated with GAC.
We know that the privacy of your personal information is important to you. In order to provide you with insurance products of the highest quality and with the service you deserve, it may be necessary for us from time to time to collect nonpublic personal and financial information about you (the "Information") and, in certain situations, to share that Information with others. The following notice describes our policies and practices with regard to your Information. |
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| HOW WE PROTECT YOUR INFORMATION |
| We maintain physical, electronic and procedural safeguards to protect the Information against unauthorized access and use. We restrict access to the Information to those employees who need access to provide products and services to you and your dependents. The personnel who have access are trained in the proper handling of the Information. Employees who violate this strict level of confidentiality are subject to our disciplinary process. |
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| CATEGORIES OF INFORMATION THAT WE COLLECT |
In the normal course of business we may collect the following types of Information:
- Information you provide on applications and other forms (including name and address)
- Data about your transactions with us (such as types of products you have purchased and your account status)
- Information gathered on our Web sites through online forms, site visit data and online information-collecting devices known as "cookies"
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| HOW WE USE YOUR INFORMATION |
- We may share your information among the Insurance Companies as permitted by law, including for routine business administration.
- We may share information with non-affiliated companies as allowed by law, such as firms that perform services on our behalf, including the administration and marketing of our products. We require these companies to meet strict privacy standards.
- We may disclose information to non-affiliated entities when required by law, such as to respond to a subpoena, to prevent fraud or to comply with an inquiry by a government agency.
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| ACCURACY OF YOUR INFORMATION |
| We strive to maintain the accuracy of Information that is in our possession about you. In order to help us maintain accuracy, you have the right to reasonably access your information. If you believe any information in our possession is inaccurate, a request can be made to amend or delete the information that you believe to be erroneous. If we concur with the request, we will amend or delete the information in question. You may write our Privacy Office at the address below to receive our complete policy on accessing and amending the Information. |
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| CHANGES TO THIS NOTICE |
| We reserve the right to change this Notice. We reserve the right to make the revised Notice effective for the Information we already have about you as well as any Information we receive in the future. If we make any material changes to our policies or practices, we will provide you with a copy of a revised Notice. We will post a copy of the current Notice on our websites. The Notice will contain in the top right-hand corner, the effective date. |
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| You may contact our Privacy Office at: |
General Agent Center
15575 North 79th Place, Suite 100
Scottsdale, AZ 85260 |
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