Document 6438688

Vehicle Service Contract - Declaration Page
The Administrator and Obligor of this Vehicle Service Contract is as follows:
Vision Warranty Corporation. The address and phone:
11449 Gulf Freeway, Houston, Texas 77034. 1-877-635-3143.
The Obligor's performance under this Contract is fully insured by First Colonial Insurance Company, a
member of Allstate Insurance Group, 1776 American Heritage Life Drive, Jacksonville, FL 32224-6688.
If a covered claim is not paid within sixty (60) days after proof of loss has been filed, You may file a claim
against First Colonial Insurance Company at the address shown or call toll free 1-800-621-4871.
CONTRACT NUMBER
AEU XXXXXXXXXXXX
Please use this number in any written or phone
communication
LEINHOLDER
ADDRESS
SELLER
M
T
P
AC L
E
TI
VE
CUSTOMER NAME
CITY, STATE, ZIP
SURCHARGES
LIFT KIT / TIRE MODIFICATION
SNOW PLOW
PHONE
COMMERCIAL / BUSINESS USE
VIN
TOTAL LOSS REFUND
CONTRACT DEDUCTIBLE (PER VISIT)
TOTAL LOSS REFUND
YEAR / MAKE
NEW / PRE-OWNED
NEW
MODEL
CUSTOMER COST
4WD/AWD
O
DIESEL
3)
4)
5)
N
2)
LEVEL.2TWO
LEVEL.3THREE WRAP
MONTHS _________________________
MILES ____________________
THIS CONTRACT IS NOT VALID UNLESS THE
COVERAGE AND TERM ARE STATED.
HYBRID
YOUR CONTRACT EXPIRES ON ______________ OR WHEN YOUR VEHICLE
30 DAY 1,000 MILE VALIDATION PERIOD - SEE THE
SECTION TITLED "GENERAL PROVISIONS" FOR DETAILS
1)
LEVEL.3THREE
TERM
TURBOCHARGER OR SUPERCHARGER
GAS
LEVEL.1ONE
ORIGINAL IN-SERVICE DATE
VEHICLE OPTIONS
2WD
CONTRACT SALE DATE
COVERAGE (SELECT ONLY ONE)
SA
ODOMETER
VEHICLE PURCHASE PRICE
PRE-OWNED
REACHES _______________ MILES, WHICHEVER OCCURS FIRST
CONTRACT ACKNOWLEDGEMENT
This Vehicle Service Contract (“Contract”) is between the Contract Holder (“You”, “Your”) named above and Vision Warranty Corporation as
Administrator (“We”, “Us”, “Our”) identified below.
By signing below, You agree that You have read, understand and agree to all terms and conditions within this Contract and this Contract is not an
insurance policy or product warranty, implied or otherwise.
THE PURCHASE OF THIS VEHICLE SERVICE CONTRACT IS NOT REQUIRED IN ORDER TO PURCHASE OR OBTAIN FINANCING FOR THIS
VEHICLE.
You and the Seller (“Seller”) named above confirm that the information stated above is accurate and complete and that the Vehicle is eligible for coverage.
If this application cannot be accepted as written, You will be notified within forty-five (45) days of Contract Sale Date and offered a revised Vehicle Service
Contract, if possible. If You do not choose to accept the revised Vehicle Service Contract or the vehicle does not qualify, the Contract Sale Price will be
refunded by the Seller.
In the event you do not receive the Contract at the time of sale, You understand that, upon acceptance of this application, the Contract will be mailed to
the address indicated above. If You do not receive the Contract within forty-five (45) days of the Contract Sale Date, please call Us at (877) 635-3143.
Additionally, You acknowledge Your understanding of the Arbitration provision in section J.
Contract Holder Signature and Date
Seller’s Representative Signature and Date
Washington Residents Only: By initialing this box, You acknowledge You have reviewed with the Seller the sections of this Contract titled: YOUR
RESPONSIBILITIES FOR SERVICE AND MAINTENANCE, GENERAL PROVISIONS, CANCELLATION OF CONTRACT, YOUR RESPONSIBILITIES
IN CASE OF A BREAKDOWN, SCHEDULE OF COVERAGE and EXCLUSIONS. The implied warranty of merchantability on the Vehicle is not waived
if this Contract has been purchased within ninety (90) days of the sale date of the Vehicle from the Seller.
VISION WARRANTY CORPORATION is the Obligor and Administrator for this Vehicle Service Contract
11449 Gulf Freeway, Houston, TX 77034
All Claims must be authorized by Us prior to repairs being started.
Any repairs completed prior to such authorization may not be covered.
FOR CLAIM SERVICE CALL: (877) 635-3143
FOR TOWING, LOCKOUT, OR EMERGENCY ROAD SERVICES CALL QUEST TOWING SERVICES: (855) 418-2338
FP1594
TX Lic. No. 640
1 of 8
(08/12)
Vehicle Service Contract Terms and Conditions
TABLE OF CONTENTS
A.
B.
C.
D.
E.
F.
G.
Definitions
General Provisions
Schedule of Coverage
Surcharges
Additional Benefits
Exclusions
Ineligible Vehicles
H.
I.
J.
K.
L.
M.
N.
Cancellation of Contract
Transfer of Contract
Arbitration
Your Responsibilities in Case of a Breakdown
Approved Repair Facility’s Guide to Filing a Claim
Your Responsibilities for Service and Maintenance
Special State Requirements and Disclosures
A. DEFINITIONS
SA
M
T
P
AC L
E
TI
VE
Throughout this Contract certain words and phrases appear in bold face type. These words have specific definitions in this document. Those definitions are found
below.
Approved Repair Facility: A repair facility licensed to perform repairs, has a Federal Employer’s Identification Number or equivalent, provides a minimum of a 12
month/12,000 mile warranty from the date of service on all repairs completed, and is approved by Us.
Authorized Amount: The total amount of a Claim, as authorized by Us, including all covered charges minus the Deductible. Any charges that exceed the Authorized
Amount are Your responsibility. Labor cost is calculated by multiplying an Approved Repair Facility’s approved labor rate by the labor time as specified in Motors or All
Data online labor guides. The manufacturer’s suggested retail pricing (“MSRP”) will be the maximum part cost paid under this Contract.
Breakdown: The inability of a Covered Part to perform the function for which it was designed due to a material defect that is not related to the action or inaction of any
non-covered part or outside influence. A gradual reduction in performance commonly referred to as “wear and tear,” will be considered a Breakdown when the wear has
exceeded the manufacturer’s published tolerances. Please refer to section F. EXCLUSIONS for a listing of conditions under which the failure of a Covered Part is not
considered a Breakdown.
Claim: A request by You for benefits under this Contract.
Covered Part: Parts listed in section C SCHEDULE OF COVERAGE corresponding to the coverage option You selected.
Deductible: The portion of the authorized repairs You must pay for each repair visit. Should a Breakdown require more than one repair visit, only one Deductible will
be charged for that Breakdown.
Expiration Date: For New and Pre-Owned Vehicle coverage, the Expiration Date will be the Contract Sale Date plus the number of months stated in the Term field.
For wrap coverage, the Expiration Date will be the Original In-Service Date plus the number of months stated in the Term field.
Expiration Mileage: For new and wrap coverage, the Expiration Mileage will be the mileage stated in the Term field. For Pre-Owned Vehicle coverage, the Expiration
Mileage is the mileage at the time of sale plus the miles stated in the Term field.
New Vehicle: A vehicle that is no older than the current calendar year minus five (5) years and whose mileage does not exceed fifty thousand (50,000) miles at the time
of sale.
Pre-Owned Vehicle: A vehicle that is no older than the current calendar year minus eleven (11) years, has less than 150,000 miles.
Vehicle: The vehicle identified in the Vehicle & Sale Information fields which meets Our underwriting guidelines for mileage, condition, vehicle type and use.
B. GENERAL PROVISIONS
N
O
This Contract is between You and Us, includes the application and terms and conditions and makes up the entire agreement regarding the service contract and related
benefits for Your Vehicle. Our obligations under this Contract are insured by an insurance policy issued by First Colonial Insurance Company or Northbrook Indemnity
Company, members of the Allstate family of companies. If a covered Claim is not paid within sixty (60) days after You have filed proof of loss with Us, You may file a
Claim directly with First Colonial Insurance Company at (800) 621-4871; 1776 American Heritage Life Drive, Jacksonville, FL 32224. In California, Connecticut and
Wyoming, You may file a Claim directly with Northbrook Indemnity Company at (800) 621-4871; 1776 American Heritage Life Drive, Jacksonville, FL 32224. In the
event that You experience a Breakdown, We will pay for or reimburse You for the Authorized Amount, in accordance with the terms and conditions contained in this
Contract.
 This Contract begins on the Contract Sale Date and expires when the Expiration Date or Expiration Mileage is reached, whichever occurs first.
 VALIDATION / WAITING PERIOD - THERE IS A THIRTY (30) DAY AND 1,000 MILES VALIDATION OR “WAITING” PERIOD FROM THE DATE OF
PURCHASE OF THE CONTRACT. EXPIRATION OF THE CONTRACT WILL BE ACCORDING TO THE TIME AND MILEAGE LIMITS OF THE PLAN
SELECTED, WHICHEVER OCCURS FIRST, WITH THE “WAITING” PERIOD OF THIRTY (30) DAYS AND 1,000 MILES ADDED TO THE SCHEDULED
EXPIRATION. THE VALIDATION OR “WAITING” PERIOD WILL NOT REDUCE THE ACTUAL TIME AND/OR MILEAGE DURING THE TERM OF THE
CONTRACT. COVERAGE WILL COMMENCE THE DAY FOLLOWING THE VALIDATION OR “WAITING” PERIOD.
 This Contract applies to Breakdowns occurring and being repaired within the fifty (50) United States, the District of Columbia and Canada.
 We reserve the right to inspect the Vehicle prior to authorizing any repair.
 The total of all benefits paid or payable under this Contract shall not exceed the price You paid for the Vehicle excluding charges for tax, title, negative equity,
license and finance and insurance products. In no event will Our liability for an individual repair visit exceed the average retail value of the Vehicle as stated in the
current online National Automobile Dealer Association (N.A.D.A.) pricing guide immediately prior to the Breakdown, less any Deductible.
 All repairs require authorization from Us. Please refer to section K. YOUR RESPONSIBILITIES IN CASE OF A BREAKDOWN.
 If You have a right to recover any funds that We have paid under this Contract, You hereby assign those rights to Us. Your rights become Our rights and You
agree to do whatever is necessary to enable Us to enforce those rights. We shall be entitled to retain only funds that reimburse Our actual costs and only after You
are fully compensated for Your Claim.
C. SCHEDULE OF COVERAGE
In the event that You experience a Breakdown, please refer to section K. YOUR RESPONSIBILITIES IN CASE OF A BREAKDOWN. Parts used to repair Your Vehicle
may be new parts, remanufactured parts, or parts of like kind and quality with mileage not exceeding the mileage on the Vehicle at the time of Breakdown, as We deem
appropriate.
All Claims must be authorized by Us prior to repairs being started.
LEVEL.1ONE – (COMPONENTS LISTED IN SECTIONS 1-3)
If You selected LEVEL.1ONE, components listed in 1 through 3 below are covered.
1) Engine: Cylinder block, cylinder head and all internally lubricated parts; intake manifold, exhaust manifolds without internal catalytic converter; water pump,
harmonic balancer and its bolt and pulley; valve covers, timing cover, timing belt and tensioner, timing chain, and gears; oil pump cover, gears, pressure relief
valve, pickup and screen; oil pan, internal fasteners, engine mounts, flywheel, turbo/supercharger and waste gate; seals and gaskets for listed parts.
2) Transmission: Transmission/transaxle case and all internally lubricated parts; extension housing, transfer case and all internally lubricated parts; torque
converter, valve body, transmission pan, viscous coupler, shift linkage, bell housing, electronic shift control unit and solenoids; flex plate, ring gear,
transmission mounts; seals and gaskets for listed parts.
3) Drive Axle: Differential housing and all internally lubricated parts; differential cover, front and rear wheel drive axle shafts; constant velocity joints and boots,
universal joints, four wheel drive engagement actuator, four wheel drive locking hubs, drive shafts, center support and bearings; drive shaft yokes; seals and
gaskets for listed parts.
LEVEL.2TWO – (COMPONENTS LISTED IN SECTIONS 1-9 (INCLUDES LEVEL1.ONE))
If You selected LEVEL.2TWO, You receive coverage for LEVEL.1ONE plus 4 through 9 below.
4) Brakes (ABS and Non ABS): Master cylinder, wheel cylinders, vacuum and hydraulic brake boosters, metal hydraulic lines and fittings, calipers, backing
plates and hardware, proportioning and combination valves, brake pedal assembly, electronic brake control unit, wheel speed sensors, pressure modulator
control/isolation dump valves, high pressure hydraulic pump, solenoids, accumulator; seals and gaskets for listed parts.
5) Air Conditioning: Condenser, compressor, evaporator, expansion valve, orifice tube, clutch, coil and pulley; idler pulley and bearing; receiver dryer, o-rings,
oil and refrigerant (when required with a covered repair due to leaks); manual climate control head, hi-low pressure cut off / cycling switch, A/C hoses and
lines; seals and gaskets for listed parts.
6) Steering: Steering gear housing and internal parts; power steering pump, its internal parts and reservoir; rack and pinion housing and internal parts; power
steering hoses, steering column shaft, couplings and bearings; pitman arm, idler arm, tie rod ends, center link; seals and gaskets for listed parts.
7) Suspension: Upper and lower control arms, shafts and bushings; stabilizer bars, bushings and links; torsion bars and their mounts and bushings, radius arms
and bushings, strut bars and their links and bushings; spindle, spindle support and steering knuckle; ball joints; seals and gaskets for listed parts.
8) Fuel: Fuel pump (mechanical or electrical), fuel pump relay, fuel distribution rails, fuel level sending unit, lift pump; seals and gaskets for listed parts.
9) Electrical: Alternator, voltage regulator, starter motor and solenoid; front and rear wiper motors; wiper motor relays and delay switch/module; washer pumps
and switches; back up light switch, stop lamp switch, neutral safety switch, glove box light switch, courtesy light and door jamb switches, ignition switch,
ignition lock cylinder and any electrical switch that is physically touched by a Vehicle occupant to activate an accessory.
FP1594
TX Lic. No. 640
2 of 8
(08/12)
LEVEL.3THREE / LEVEL.3THREE WRAP
If You selected LEVEL.3THREE or LEVEL.3THREE WRAP, components covered for LEVEL.2TWO are covered, along with all other parts on the Vehicle subject to
section F. EXCLUSIONS.
D. SURCHARGES
M
T
P
AC L
E
TI
VE
Commercial Use: The Commercial Use surcharge must be selected for the Vehicle to be covered if the Vehicle is intended for commercial use by a single driver during
the execution of business and meets any of the following criteria: the vehicle is registered to a business, or has advertising signage permanently displayed on the
exterior, or has commercial plates. Vehicles equipped for or used in the following industries are absolutely excluded: farming, forestry, agriculture, welding, road
construction or oil field industries; taxicab, rental, limousine, auto transport, shuttle or livery service; any emergency response vehicles either private or municipal, private
security, mail carrier or any other pick up or deliver services; waste removal, dump truck, tow truck, hazardous material transportation; military, federal state, city or
government use; or fleet/pool vehicles used by multiple drivers.
Snow Plow: The Snow Plow surcharge must be selected for the Vehicle to be covered if the Vehicle is equipped with a snow plow at the time of Vehicle purchase. The
blade size must not exceed eight and one half (8.5) feet. The snow plow must meet the manufacturer’s recommendations for the vehicle on which it is installed. The
snow plow and all of its assembly are excluded from coverage. Installation of a snow plow that voids the original manufacturer warranty will also void the coverage
provided under this Contract.
Lift Kit/Tire Modifications: The Lift Kit/Tire Modifications surcharge must be selected for the Vehicle to be covered if the Vehicle is equipped with oversized tires or
body or suspension lifts at the time of Vehicle purchase. The lift kit/tire modifications and all of their assemblies that are in addition to factory installed parts are excluded
from coverage. The maximum increase for a body/suspension lift combined cannot exceed six (6) inches. The maximum tire height modification allowed is four (4) inches
larger than the manufacturer specifications. Tires considered as aggressive off-road tires are specifically excluded. In order for the Vehicle to be eligible for coverage, the
odometer must be recalibrated to reflect the true mileage due to the modification, and the cost of such recalibration is excluded from coverage. Any modification that voids
the original manufacturer warranty will also void the coverage provided under this Contract.
E. ADDITIONAL BENEFITS
F. EXCLUSIONS
This Contract excludes the following parts and services:
a) Any part not specifically listed in section C. SCHEDULE OF COVERAGE for the Coverage Option You selected, unless You selected LEVEL.3THREE
or LEVEL.3THREE WRAP for Your Coverage Option.
b) Accessory drive belts, external nuts, bolts and fasteners, clamps, hoses not specifically listed in the Coverage Option You selected, distributor cap
and rotor, spark plugs and wires, clogged fuel injectors where a mechanical/electrical failure has not occurred, glow plugs, tires, wheels and wheel
covers, valve stems, freeze plugs, shock absorbers for non-electrical failures, radiator cap, windshield wiper blades/arms, standard transmission
clutch parts (including pressure plate, clutch disc, pilot bearing, throw-out bearing, clutch engagement arm and pivot), steering wheel, batteries
(either stand alone or integral to a component), hybrid power packs, battery cables, fuses, fusible links and circuit breakers, brake drums, rotors,
pads and shoes, brake cables, sub-frame, frame, frame bushings, convertible top and frame, glass, lenses, sealed beams and light bulbs, keys,
Xenon headlight assemblies, exterior Light Emitting Diode (LED) assemblies, exhaust pipes, mufflers and resonators, hangers and clamps, filters
and filter housings, crankcase ventilation system, exhaust gas recirculation pipes, hoses, and check valves, charcoal canister, catalytic converter,
fuel tank vent valve, any parts or components for natural gas/propane fuel systems, safety restraint systems or any part thereof, cellular phone,
manufacturer’s satellite or cellular vehicle diagnostic/communication systems or any part thereof, conversion van appliances, radar detector, solar
powered devices, door handles (except for integral electrical failures).
c) Loss of fuel, trim, upholstery, insulation, carpet and paint, air or water leaks or wind noise, squeaks and rattles, jack and tool kit, wheel lugs and
lug nuts, shop supplies, environmental waste charges or disposal fees, lost or missing parts, electronic diagnostic equipment fees, freight, vehicle
body parts including but not limited to: bumpers, body panels, fasteners and mounts, moldings and outside ornamentation, bright metal parts,
door stops, hinges, and weather stripping.
d) Any non-manufacturer installed parts including but not limited to: turbochargers, superchargers, convertible tops, audio, navigation, and security
systems.
e) Replacement of oil, lubricants, coolants, additives and/or other fluids, except in conjunction with the repair of a Covered Part. Replacement of A/C
refrigerant and/or oil unless in conjunction with a leak resulting from the failure of a Covered Part.
f) The use of parts that improve Your Vehicle beyond its condition immediately prior to the Breakdown.
g) Any service considered to be regular maintenance, or a service, labor, or adjustment operation completed to correct a complaint where a Covered
Part has not failed.
h) Suspension alignment (unless required in conjunction with the repair of a Breakdown).
i) Any part or repair that a repair facility or manufacturer recommends or requires to be repaired, replaced, adjusted or updated (including updating
software or programming), in conjunction with a covered repair when a Breakdown of that part has not occurred. This includes modifications,
replacement or alteration of original systems necessitated by the replacement of an obsolete, superseded, redesigned, or unavailable part.
This Contract excludes the following conditions:
a) Any Breakdown resulting from damage caused to a Covered Part by impact or any other external force known or unknown, collision, bent or
twisted parts, fire, terrorism, theft, vandalism, riot, explosion, restricted oil passages, rust or corrosion, salt, environmental damage, contamination,
oxidation, carbon, sludge, varnish, damage caused when the engine exceeds the manufacturer’s maximum recommended operating temperature
(as indicated by gauges, warning lights, or audible warning sounds, warped or melted parts), lack of proper quality or quantity of fluids or
lubricants, and acts of nature including but not limited to lightning, earthquake, windstorm, volcanic eruption, and freezing.
b) Any Breakdown that existed prior to the Contract Sale Date or reported after the expiration of the Contract.
c) Any repair(s) started without receiving prior authorization from Us, except for emergency repairs. (Please refer to item #9 in section K. YOUR
RESPONSIBILITIES IN CASE OF A BREAKDOWN.)
d) Any Breakdown caused by Your failure to follow the instructions in section M. YOUR RESPONSIBILITIES FOR SERVICE AND MAINTENANCE or any
Breakdown where maintenance records pertaining to a Breakdown have been requested by Us but cannot be produced or verified.
N
1)
O
SA
You are not required to pay a Deductible for any of the following Additional Benefits:
Roadside Assistance Services:
1) TOWING/WRECKER SERVICE: In the event Your Vehicle becomes disabled due to any mechanical failure which renders Your Vehicle inoperable, Your
Vehicle may be towed anywhere within the first 10 miles. After 10 miles, Your Vehicle towed to nearest qualified repair facility, no matter how far the
distance.
2) GASOLINE DELIVERY: In the event Your Vehicle runs out of gas, We will arrange for a service provider to deliver an emergency supply of gas for Your
Vehicle and will pay for the gas delivery service, excluding the cost of the gas. You are responsible for the cost of the emergency supply of gas at the time of
delivery.
3) FLAT TIRE CHANGE: In the event of a flat tire on Your Vehicle, We will arrange for a service provider to mount an inflated spare tire provided by You and will
pay for the flat tire service call.
4) BATTERY-JUMP SERVICE: In the event Your Vehicle will not crank due to a weak or “run-down” battery, We will arrange for a service provider to boost or
jump-start the battery and will pay for the battery-jump service.
5) LOCKOUT SERVICES: In the event the keys for Your Vehicle are lost, broken or accidentally locked in Your Vehicle, or Your Vehicle has a frozen lock, We
will arrange for a service provider to unlock Your Vehicle and will pay for the locksmith service, excluding the cost of replacement keys. You are responsible
for the cost of any replacement keys at the time of service.
6) CONCIERGE SERVICES: In the event of a ROADSIDE ASSISTANCE Work order, We will assist You in arranging for alternative transportation, calling Your
home or office, or arranging any other reasonable services to ease the inconvenience of the breakdown. YOU ARE SOLELY RESPONSIBLE FOR PAYMENT
DIRECTLY TO THE SERVICE PROVIDER OF ANY CONCIERGE SERVICES ARRANGED.
Note: The 24-Hour Roadside Assistance services are provided through Quest Towing Services, 106 West Tolles Drive, St. Johns, MI 48879, and their toll free phone
number is (855) 418-2338. Be sure to have Your Contract number available.
Rental Car Reimbursement: If a covered Breakdown requires Your Vehicle to be left at an Approved Repair Facility, You may be eligible for Rental Car
Reimbursement. Payments are limited to the actual rental cost not to exceed thirty-five dollars ($35) per day excluding expenses for gasoline, insurance, mileage or
maintenance charges. Each eight (8) hours of labor or portion thereof will provide one (1) day of rental not to exceed seven (7) days. The rental car must be rented from
a licensed rental agency. You must be either the primary signee or listed as an additional driver on the rental agreement. Rental Car Reimbursement shall not continue
beyond the day on which the repairs are completed. Car rental is not provided for delays because of shop scheduling or for work not covered under this Contract. You
are subject to the terms and conditions of the rental car company. For instructions on filing a claim for reimbursement, contact Us at (877) 635-3143
Trip Interruption: In the event that a covered Breakdown occurs more than one hundred (100) miles from Your permanent residence and prior to Your destination that
results in an Approved Repair Facility keeping the Vehicle overnight, We will reimburse You for unplanned receipted lodging and restaurant expenses, up to a
maximum of one hundred dollars ($100) per day for up to three (3) days from the date that the repair order was written, or the period of time it took to repair Your
Vehicle, whichever is less. For instructions on filing a claim for reimbursement, contact Us at (877) 635-3143.
Manufacturer’s Deductible Reimbursement: If a part is replaced under the manufacturer’s warranty and that same part is covered under this Contract, We will pay the
deductible that the manufacturer charged up to a $100.00 maximum.
2)
FP1594
TX Lic. No. 640
3 of 8
(08/12)
e)
M
T
P
AC L
E
TI
VE
3)
Any Breakdown caused by non-manufacturer alterations made to Your Vehicle before or after the Contract Sale Date. Alterations include, but are
not limited to: emissions equipment removal or modification, custom or add-on parts, trailer hitches, engine, offset rims, frame or suspension
lowering.
f) Any loss if the odometer has failed, been broken, disconnected or altered, or if for any reason the Vehicle’s actual accumulated mileage cannot be
determined.
g) Any charges or costs for inconvenience, loss of time, loss of income, commercial loss or any other consequential losses or expenses not
specifically covered by this Contract.
h) Liability for consequential or incidental damage to property or injury or death of any person.
i) Any loss caused by faulty or negligent auto repair work, improper servicing, or installation of defective parts.
j) Any Breakdown if a manufacturer has announced its responsibility through any means, including but not limited to public recalls and special
policies.
k) Any Breakdown covered by any limited warranty, manufacturer’s warranty, repairer’s guarantee, road club, or any other guarantee, warranty, or
insurance policy, whether collectible or not.
l) Emergency Road Services exclude the following expenses, including but not limited to: recovery expenses due to accident, fire or flood; parts,
products, storage or the cost for gasoline; service(s) performed in a dealership, garage or service station; service(s) performed in areas not
regularly traveled (such as sand beaches, open fields, forests and areas not passable due to construction); service(s) needed due to an act of
nature, etc.; charging a battery or delivery and repair of tires; service(s) other than that provided by a commercial garage or service station
(payment will not be made to private parties or unlicensed facilities);removing/installing snow tires, repairs to studs, mounting and dismounting
snow chains; clearing or entering snowbound driveways; shoveling vehicles out of snow banks or shoveling snow from around a vehicle; local
tolls or parkway charges; service to a vehicle with an expired or missing safety inspection sticker, license plate sticker, and/or emission sticker(s)
where required by law; and any other expenses not specifically mentioned as covered.
This Contract excludes the following uses:
a) Any Breakdown resulting from neglect, abuse or misuse of Your Vehicle, or failure to protect Your Vehicle from further damage when any
Breakdown has occurred, or if You have used Your Vehicle in any manner not recommended by the manufacturer.
b) Any Breakdown caused by loading the Vehicle in any way beyond the limitations established by the manufacturer.
c) Commercial Use except for eligible Vehicles when the Commercial Use surcharge was selected and paid.
G. INELIGIBLE VEHICLES
SA
The following vehicles are ineligible under this Contract:
1) Any imported vehicle that was not originally manufactured to meet U.S. Federal Motor Vehicle Standards.
2) Any vehicle that was reconstructed from salvage, declared a total loss, declared a lemon, or if the original manufacturer’s warranty was voided for any reason.
3) Any vehicle used for any competitive driving or racing.
4) Any vehicle that is or will be used/equipped or identified as: farming, forestry, agriculture, welding, road construction or oil field industries; taxicab, rental,
limousine, auto transport, shuttle or livery service; emergency response vehicles including police, fire, search and rescue, ambulance, paramedic, or security;
mail carrier or any other pick up or delivery services; waste removal, dump truck, tow truck, hazardous material transportation; federal, state, or city
government, or military use; fleet/pool vehicles used by multiple drivers.
5) Any vehicle equipped with a snow plow or lift kit/tire modification, unless the Snow Plow or Lift Kit/Tire Modification surcharge was selected and paid.
6) Any vehicle that has the following characteristics: dump bed, step-van, high-cube van, incomplete vehicles, right hand steering vehicles, or vehicles that have
special bodies designed for commercial use.
7) Any vehicle that is not a New Vehicle or Pre-Owned Vehicle as defined in this Contract.
8) Any vehicle where the Contract was not purchased at the time of vehicle purchase, unless the Vehicle meets the criteria for New Vehicle coverage.
H. CANCELLATION OF CONTRACT
N
O
You may cancel this Contract by submitting a written request to the Seller containing a copy of Your Contract and the current mileage on Your Vehicle. During the first
sixty (60) days from the Contract Sale Date, We or the Seller will refund You 100% of the Contract Sale Price, less any Claims paid on Your Contract. After the first
sixty (60) days from the Contract Sale Date, We or the Seller will refund You a pro-rated amount of the Contract Sale Price, based on the lesser of the months or miles
remaining, less any Claims paid (unless cancellation is due to a total loss and the Total Loss Refund option was selected, or otherwise stated in the SPECIAL STATE
REQUIREMENTS AND DISCLOSURES section), and less a seventy-five dollar ($75) cancellation fee (unless otherwise stated in the SPECIAL STATE
REQUIREMENTS AND DISCLOSURES section).
We may cancel this Contract during the first sixty (60) days of the Contract Sale Date for any reason. After sixty (60) days, We may cancel this Contract for material
misrepresentation or fraud at time of sale, non payment of Contract Sale Price, or if the Vehicle is determined to be ineligible for coverage under section G. INELIGIBLE
VEHICLES. If We cancel this Contract, We or the Seller will refund You 100% of the Contract Sale Price, less any Claims paid on Your Contract.
If Your Contract is financed, the lender has the right to receive any portion of the cancellation refund amounts. If Your Vehicle is repossessed, stolen or declared a
total loss, You authorize the lender to cancel this Contract.
Total Loss Refund: If this option is selected and paid for by You. You will be refunded Your full purchase price of this Contract if Your Vehicle is deemed a total loss
by your primary automobile insurance provider due to collision or acts of God, during the term of Your Contract. Maximum refund amount cannot exceed the purchase
price of Your Contract, with a maximum limit of liability of $2,000 or the current NADA Loan Value of Your Vehicle, whichever is less. Proof of total loss must be
submitted to Us with the cancellation request paperwork.
I. TRANSFER OF CONTRACT
You may transfer this Contract to a private party, provided that:
1) The Contract has not been previously transferred;
2) The remaining portion of the original manufacturer’s warranties have been transferred to the new owner;
3) Your Vehicle has not been sold or traded to or through any automobile dealer, auto broker, auto auction or financial institution;
4) You provide the new owner all records confirming that maintenance has been completed pursuant to the Contract terms; and
5) You submit a completed transfer request form to Us within thirty (30) days of an ownership change. You must include:
a) An odometer statement for Your Vehicle, and
b) A seventy-five dollar ($75) transfer fee.
To transfer this Contract please contact the Seller or Us, who will provide You with the appropriate transfer form.
J. ARBITRATION
It is understood and agreed that the transaction evidenced by this Contract takes place in and substantially affects interstate commerce. All disputes between the parties
are subject to binding arbitration, including disputes concerning the arbitrability of disputes, disputes related to the making or administration of this Contract, disputes
regarding recovery of any Claim or refund under this Contract, and disputes arising out of or relating in any way to the sale or marketing of this Contract. The parties
agree to attempt to resolve any dispute through informal negotiation. The parties agree to contact each other about a dispute before initiating any legal action. If the
parties are unable to resolve any dispute through informal negotiations, the parties agree to submit all disputes to arbitration under the Commercial Arbitration Rules of
the American Arbitration Association (AAA) in effect at the time the dispute arises. All preliminary issues of arbitrability of any dispute will be decided by the arbitrator.
1) The arbitration shall take place in Your County of residence unless another location is mutually agreed upon by the parties. The arbitration shall take place
before a single arbitrator selected in accordance with the Commercial Arbitration Rules of the AAA. AAA rules and forms will be obtained and all claims shall
be filed at www.adr.org or at any AAA office.
2) The cost of the arbitration proceeding, including the filing fee, shall be borne by Us. Each party must bear the cost of its own attorneys, experts, witness fees,
and other arbitration-related expenses.
3) It is understood and agreed that the arbitration shall be binding upon the parties. The parties acknowledge that they are waiving their right to seek remedies in
court, including the right to a jury trial. YOU UNDERSTAND THAT YOU ARE AGREEING THAT IF A DISPUTE ARISES BETWEEN YOU AND US, YOU
WILL NOT SUE US IN COURT, YOU ARE NOT ENTITLED TO A JURY TRIAL ON ANY CLAIMS ARISING IN RELATION TO THIS CONTRACT, AND THAT
AN ARBITRATOR WILL RESOLVE ANY DIFFERENCES THAT MAY ARISE BETWEEN YOU AND US. The arbitrator shall be prohibited from awarding
punitive, consequential, special, incidental, and exemplary damages. The arbitrator may award a party only its actual damages and the arbitrator may award
equitable relief including injunctive relief. You agree not to participate as a representative or member of any class of claimants proceeding against Us in a
judicial forum or in an arbitral forum. An arbitration award may not be set aside in later litigation except upon the limited circumstances set forth in the Federal
Arbitration Act, 9 U.S.C. §1 et. Seq. An award in arbitration will be enforceable under the Federal Arbitration Act by any court having jurisdiction.
4) All limitation periods that would otherwise be applicable shall apply to any arbitration proceedings.
If any portion of this arbitration provision is deemed invalid or unenforceable, the remaining portions of this arbitration provision shall nevertheless remain
valid and in force. If there is a conflict or inconsistency between this arbitration provision and the other provisions of this Contract or any prior Contract, this
arbitration provision shall govern. This provision shall be governed by the Federal Arbitration Act.
Arbitration does not apply in the following states: AR, D.C., GA, MD and WI.
FP1594
TX Lic. No. 640
4 of 8
(08/12)
K. YOUR RESPONSIBILITIES IN CASE OF A BREAKDOWN
All Claims must be authorized by Us prior to repairs being started.
Any repairs completed prior to such authorization may not be covered.
SA
M
T
P
AC L
E
TI
VE
FOR CLAIM SERVICE CALL: (877) 635-3143
FOR TOWING, LOCKOUT, OR EMERGENCY ROAD SERVICES CALL QUEST TOWING SERVICES: (855) 418-2338
You are responsible for all expenses and repair costs if it is determined that the Breakdown is not covered under this Contract. If Your Vehicle incurs a Breakdown, it
is Your responsibility to ensure that You and the Approved Repair Facility follow the procedures listed below.
1) Prevent Further Damage: You must take all reasonable means to protect Your Vehicle from further damage. Example: Warning lights illuminated in the
dashboard indicate that You should pull over and stop operating Your Vehicle immediately. If Your Vehicle is disabled or if it is unsafe to drive, please call for
towing assistance at the number above. This Contract will not cover additional damage caused by Your failure to prevent further damage.
2) Return Your Vehicle to the Seller: If it is not possible to return Your Vehicle to the Seller, contact Us for an Approved Repair Facility. If Your Vehicle
has a Breakdown and requires towing, please call for towing assistance at the number above. Have Your Approved Repair Facility contact Us prior to
authorizing any diagnosis.
3) Copy Your Contract: Provide the Approved Repair Facility with a copy of the front of this Contract and a copy of section L. APPROVED REPAIR
FACILITY’S GUIDE TO FILING A CLAIM.
4) Authorize Diagnosis: You must authorize the Approved Repair Facility to complete all that is necessary to accurately diagnose the cause of Your
Vehicle’s Breakdown and provide a complete estimate for the repair. You will be responsible for these charges if the Breakdown is not covered under this
Contract.
5) Obtain Authorization for Payment from Us: Before any repair is made, instruct Your Approved Repair Facility to contact Us to obtain prior authorization
for the Claim. We may require additional inspection of the Vehicle to verify the reported cause of Breakdown. It is Your responsibility to ensure all repairs
have been authorized by Us. The amount authorized by Us is the maximum amount that will be paid for repairs covered under this Contract. Any additional
amounts must receive prior authorization.
6) Authorize the Repair: You must not authorize repairs until We verify that the Breakdown is covered under this Contract and issue an authorization number
to the Approved Repair Facility. Even though We authorize payment for the repair You must authorize the repair to be completed.
7) Pay Applicable Deductible: We will reimburse the Approved Repair Facility or You for the Authorized Amount. You must pay the Approved Repair
Facility Your Deductible and any charges not included in the Authorized Amount.
8) Request Reimbursement: To obtain payment for a covered Breakdown, You or the Approved Repair Facility must submit a legible copy of the repair
invoice to Us. Repair invoices must include the following: authorization number, Authorized Amount, Your name, address, phone number and signature;
repair facility name, address, and phone number; Vehicle Identification Number (VIN), Vehicle mileage and repair date; Your description of the Breakdown
and the repair facility’s description of the diagnosis and repair; part numbers, part descriptions and prices; labor hours, labor descriptions, labor rate; and the
total amount requested for payment. All documents pertaining to a Claim must be submitted to Us within ninety (90) days from the date repairs are completed.
Failure to provide receipts within this time period may result in the denial of reimbursement. When submitting Your Claim for payment, send only photocopies
of Your receipts. Keep the originals for Your records.
9) Emergency Repairs: A Breakdown of serious and urgent nature which renders the Vehicle inoperable or unsafe to operate for transportation purposes may
occur when Our offices are closed. You may at Your discretion authorize the necessary emergency repairs. If any portion of the repair is being performed
during Our normal business hours, You must have the repair facility stop working on Your Vehicle and contact Us as soon as We are open for business. You
are responsible for all expenses and repair costs if it is determined that the failure or the Breakdown does not qualify as an emergency repair as defined by
this Contract.
L. APPROVED REPAIR FACILITY’S GUIDE TO FILING A CLAIM
All Claims must be authorized by Us prior to repairs being started.
Any repairs completed prior to such authorization may not be covered.
FOR CLAIM SERVICES CALL: (877) 635-3143
FOR TOWING, LOCKOUT, OR EMERGENCY ROAD SERVICES CALL QUEST TOWING SERVICES: (855) 418-2338
N
O
To assist in filing a Claim, the Approved Repair Facility may use the following as a guide:
1) Obtain Contract Information: Make a photocopy of the front page of this Contract.
2) Obtain Diagnosis Authorization: The Vehicle may need to be inspected and/or disassembled by the repair facility in order to diagnose the Breakdown and
estimate the repair’s cost. Obtain the Contract Holder’s authorization prior to performing diagnosis. Contract Holder will be responsible for all charges if the
Breakdown is not covered under this Contract. The Contract will cover reasonable diagnosis for covered repairs as provided by Motors, All Data or Mitchell
on Demand, which are nationally recognized online labor time guides. Save all parts, fluids and filters. Do not clean any parts without Our authorization.
3) Obtain Authorization for Payment from Us: After the diagnosis has been completed, but prior to any repairs being started, contact Us to obtain
authorization and provide Us with a complete estimate including all part numbers, part prices and labor involved. Upon approval, We will provide an
authorization number and an Authorized Amount. Any charges that exceed the initial Authorized Amount must receive additional approval from Us to be
paid.
4) Call the Contract Holder: Once the Claim is authorized by Us, the Contract Holder must provide the repair facility with approval to complete authorized
repairs.
5) Complete the Authorized Repair.
6) Request Reimbursement: To obtain payment for a covered Breakdown, the Approved Repair Facility must submit a legible copy of the repair invoice to
Us. Repair invoices must include the following: authorization number, Authorized Amount; Contract Holder’s name, address, phone number and signature;
Approved Repair Facility’s name, address, and phone number; Vehicle Identification Number (VIN), Vehicle mileage and repair date; the Contract Holder’s
description of the Breakdown and the repair facility’s description of the cause and correction; part numbers, part descriptions and prices; labor hours, labor
descriptions, and labor rate and total amount requested for payment. All repair invoices must be received by Us within ninety (90) days of the completion of the
authorized repairs.
Claims should be submitted to:
VISION WARRANTY CORPORATION
11449 Gulf Freeway Houston, TX 77034
(877) 635-3143
M. YOUR RESPONSIBILITIES FOR SERVICE AND MAINTENANCE
You must maintain the Vehicle in accordance with the manufacturer’s published maintenance requirements and maintain proper fluid levels. If You do not have the
Vehicle manufacturer’s published maintenance requirements, You may obtain them from the local dealership representing Your Vehicle’s manufacturer.
Before any repair is authorized, We may require You to provide records showing that You have properly maintained Your Vehicle. You must retain all receipts as proof
of maintenance. Acceptable receipts will include Your name and signature, date, mileage, services performed, year, make, model, of the Vehicle and Vehicle
Identification Number (VIN). Reimbursement of maintenance services is not covered under this Contract.
If You perform the required maintenance on the Vehicle yourself, You must maintain a log noting the date, mileage and type of maintenance service performed. Each log
entry must have a corresponding receipt, dated within the two weeks prior to the date on the log, for the materials needed for the service performed (e.g., filters, oils and
lubricants). Receipts that do not reflect a date within two weeks of the service date are not acceptable.
FP1594
TX Lic. No. 640
5 of 8
(08/12)
N. SPECIAL STATE REQUIREMENTS AND DISCLOSURES
THIS CONTRACT IS AMENDED TO COMPLY WITH THE FOLLOWING REQUIREMENTS AND DISCLOSURES FOR THE SELLER’S STATE:
M
T
P
AC L
E
TI
VE
Alabama: A twenty-five dollar ($25) cancellation fee is applicable. The CANCELLATION OF CONTRACT section is amended to add the following: If You are the original
Contract Holder and You cancel this Contract within sixty (60) days of the original Contract Sale Date, a ten percent (10%) penalty per month shall be added to a refund
that is not made within forty-five (45) days of return of this Contract to Us.
Alaska: CANCELLATION OF CONTRACT section is amended as follows: We will retain a cancellation fee of 7.5% of the unearned pro rata Contract Sale Price, not to
exceed twenty-five dollars ($25); to be based on the days in force, as related to Your Contract’s term.
Arizona: Nothing in this section prevents, limits, or waives Your rights to file a complaint against Us, Vision Warranty Corporation, or seek remedy available thereto, with
the Arizona Department of Insurance.
INELIGIBLE VEHICLES section (1) is amended to add the following: In the event a Contract is issued on this type of ineligible vehicle, this Contract is valid and covered
Breakdowns would be covered.
CANCELLATION OF CONTRACT section is amended as follows: A twenty-five dollar ($25) cancellation fee is applicable.
You may cancel this Contract by submitting a written request to the Seller containing a copy of Your Contract and the current mileage on Your Vehicle. During the first
sixty (60) days from the Contract Sale Date, We or the Seller will refund You 100% of the Contract Sale Price with no deductions for any Claims or pending Claims.
After the first sixty (60) days from the Contract Sale Date, We or the Seller will refund You a pro-rated amount of the Contract Sale Price, based on the lesser of the
months or miles remaining, less a twenty-five dollar ($25) cancellation fee, with no deductions for any Claims or pending Claims.
We may not cancel or void this Contract or any provisions of this Contract due to (1) Our acts or omissions in failing to provide correct information or to perform services
or repairs in a timely, competent, and workmanlike manner, (2) A Breakdown that existed prior to the Contract Sale Date, (3) prior use or unlawful acts relating to the
covered Vehicle, (4) Our misrepresentation, and (5) ineligibility of the Vehicle for coverage under the program.
Arkansas: CANCELLATION OF CONTRACT section is amended as follows: A fifty dollar ($50) cancellation fee is applicable.
Colorado: Our obligations under this Contract are guaranteed by a reimbursement insurance policy issued by First Colonial Insurance Company, Policy Number:
VWCTX001.
Connecticut: Unresolved complaints may be addressed to the State of Connecticut, Insurance Department P.O. Box 816, Hartford, CT 06142-0816, Attention:
Consumer Affairs. If the warranty period is less than one year, the coverage is automatically extended if the product is being repaired when the warranty expires.
The first sentence of the CANCELLATION OF CONTRACT section is amended as follows: You may cancel this Contract at any time for any reason by submitting a
written request to the Seller containing a copy of Your Contract and the current mileage on Your Vehicle.
N
O
SA
Performance to you under this Contract is guaranteed by a Connecticut approved insurance company, Northbrook Indemnity Company at [1776 American
Heritage Life Drive, Jacksonville, Florida, 32224, (800) 621-4871].
Georgia: Exclusion 2(a) is revised to remove “sludge”.
Exclusion 2(b) is deleted in its entirety and replaced with the following: 2(b). A Breakdown known to You or reasonably should be known to You that existed prior to the
Contract Sale Date, or any Breakdown reported after the expiration of the Contract.
Exclusion 2(e) is deleted in its entirety and replaced with the following: 2(e). Any Breakdown that occurs after any alterations have been made to Your Vehicle by You
or with Your knowledge (whether before or after the Contract Sale Date), or if You are using or have used Your Vehicle in a manner not recommended by the
manufacturer, including but not limited to: the failure of any custom or add-on part, trailer hitches, engine modifications, offset rims, frame or suspension lowering.
Exclusion 2(f) is deleted in its entirety and replaced with the following: 2(f). Repair costs or expenses if the odometer of the Vehicle has broken or becomes inoperable or
unreliable for any reason and odometer repairs were not made immediately at the time of failure, or if the odometer has been tampered with, disconnected, or altered in
any way while owned by You.
CANCELLATION OF CONTRACT section is deleted in its entirety and replaced with the following: We may not cancel this Contract except for material
misrepresentation or fraud at time of sale or non-payment of Contract Sale Price. If We cancel this Contract, We or the Seller will refund You 100% of the Contract Sale
Price. Written notice of cancellation will be mailed to You at least ten (10) days prior to the cancellation of this Contract for non-payment of the Contract Sale Price. At
least thirty (30) days written notice of cancellation will be mailed to You for all other reasons. Cancellation will comply with Section 33-24-44 of the Georgia Code.
Cancellation fee is not applicable.
You may cancel this Contract at any time. If You cancel this Contract within the first sixty (60) days and no Claims have been filed, We will refund the entire Contract
Sale Price with no deductions for any Claims or pending Claims. If this Contract is cancelled after the first sixty (60) days or a Claim has been filed, We will refund the
amount of the Contract Sale Price according to the pro-rata method reflecting the greater of the days in force or the miles driven with no deductions for any Claims or
pending Claims. An administrative fee, not to exceed the lesser of ten (10%) of the pro rata refund amount or fifty dollars ($50),will be applied if the Contract is
cancelled by You.
If Your Contract is financed, the lender has the right to receive any portion of the cancellation refund amounts. If Your Vehicle is repossessed, stolen or declared a total
loss, You authorize the lender to cancel this Contract.
Hawaii: CANCELLATION OF CONTRACT section is amended as follows: If We cancel the Contract, notice of such cancellation will be delivered to You by registered
mail five (5) days prior to cancellation. The notice of cancellation will state the reason for cancellation and will include any reimbursement required. The cancellation will
be effective as of the date of termination as stated in the notice of cancellation. If cancellation is due to non-payment of the Contract Sale Price, material
misrepresentation, or a substantial breach of duties under the Contract, such notice will not be required. A ten percent (10%) penalty per month shall be added to a
refund that is not made within forty-five (45) days of return of this Contract to Us.
Idaho: Coverage afforded under this Contract is not guaranteed by the Idaho Insurance Guarantee Association.
CANCELLATION OF CONTRACT section is amended as follows: A fifty dollar ($50) cancellation fee is applicable.
Illinois: CANCELLATION OF CONTRACT section is amended as follows: If You elect cancellation, We may retain a cancellation fee not to exceed the lesser of ten
(10%) of the Contract Sale Price or fifty dollars ($50). If You are the original Contract Holder and You cancel this Contract within sixty (60) days of the original Contract
Sale Date, a ten percent (10%) penalty per month shall be added to a refund that is not made within forty-five (45) days of return of this Contract to Us.
Indiana: Your proof of payment to the Seller for this Contract shall be considered proof of payment to First Colonial Insurance Company, which guarantees Our
obligations to You, providing such insurance was in effect at the time You purchased this Contract.
Iowa: Iowa residents only may contact the Iowa Insurance Commissioner at the following address: Iowa Insurance Department, 6th Floor, Lucas State Office Building,
Des Moines, Iowa 50319. CANCELLATION OF CONTRACT section is amended to add the following: If You are the original Contract Holder and You cancel this
Contract within sixty (60) days of the original Contract Sale Date, a ten percent (10%) penalty per month shall be added to a refund that is not made within thirty (30)
days of return of this Contract to Us. If We cancel the Contract, written notice of such cancellation will be mailed to You within fifteen (15) days of the date of
cancellation.
Kentucky: Transfer fee is not applicable. Cancellation fee is not applicable.
Louisiana: CANCELLATION OF CONTRACT section is amended to include the following: After sixty (60) days, We cannot cancel this Contract except:
1. If there has been a material misrepresentation or fraud at the time of sale of the Contract;
2. If You failed to maintain the motor Vehicle as prescribed by the manufacturer; or
3. For non-payment of the Contract Sale Price by You, in which case We will provide You notice of cancellation by certified mail.
The refund will be based upon a pro-rata basis. In calculating a refund, no deduction shall be allowed for any Claim that has been paid under the Contract. If You have
requested cancellation within the first 30 days, full refund, minus any cancellation fee, shall be issued. Cancellation fees will not exceed $50.00. The “less any Claims
paid” language does not apply in the State of Louisiana. The lender/lessor will be named on the refund check when financing has been provided for the Contract Sale
Price. In the event of repossession or total loss, lender/lessor may request cancellation of this Contract and will be the sole named payee. This Contract is cancellable
and refundable upon Your request.
Maine: CANCELLATION OF CONTRACT section is amended as follows: A cancellation does not apply in Maine. If You are the original Contract Holder and You
cancel this Contract within sixty (60) days of the original Contract Sale Date, a ten percent (10%) penalty per month shall be added to a refund that is not made within
forty-five (45) days of return of this Contract to Us.
Maryland: Section D. SURCHARGES, Snow Plow section, is amended as follows: Installation of a snow plow that causes the original manufacturer warranty to no longer
be in effect will terminate the coverage provided under this Contract.
Section D. SURCHARGES, Lift Kit/Tire Modifications section, is amended as follows: Any modification that causes the original manufacturer warranty to no longer be in
effect will terminate the coverage provided under this Contract.
Section G. INELIGIBLE VEHICLES, item 2 is amended to state the following: 2) Any vehicle that was reconstructed from salvage, declared a total loss, declared a lemon,
or if the original manufacturer’s warranty is no longer in effect for any reason.
CANCELLATION OF CONTRACT section is amended as follows: If You are the original Contract Holder and You cancel this Contract within sixty (60) days of the
original Contract Sale Date, and if no Claims have been paid, a full refund will be issued. The cancellation fee does not apply in Maryland. A ten percent (10%) penalty
per month shall be added to a refund that is not made within forty-five (45) days of return of this Contract to Us.
After forty five (45) days, We cannot cancel this Contract except:
1. when there exists:
a. a material misrepresentation or fraud at the time of sale of the Contract;
b. a matter or issue related to the risk that constitutes a threat to public safety; or
c. a change in the condition of the risk that results in an increase in the hazard insured against;
2. for non-payment of premium; or
3. due to the revocation or suspension of the driver’s license or motor vehicle registration of the named insured or covered driver under the policy and for reasons
related to the driving record of the named insured or covered driver.
If Your Contract is financed, the insurer shall return any gross unearned premiums that are due under the insurance contract, computed pro rata, and excluding any
expense constant, administrative fee, or any nonrefundable charge filed with and approved by the Commissioner.
FP1594
TX Lic. No. 640
6 of 8
(08/12)
The transfer fee does not apply in Maryland.
Minnesota: CANCELLATION OF CONTRACT section is amended to add the following: A ten percent (10%) penalty per month must be added to a refund that is not
paid or credited within forty-five (45) days after return of the Contract to the provider. If We cancel the Contract, written notice of such cancellation will be mailed to You
within fifteen (15) days of the date of cancellation and will state the effective date and the reason for cancellation; five (5) days written notice will be mailed to You for nonpayment of premium, material misrepresentation or substantial breach of duties by You.
M
T
P
AC L
E
TI
VE
MISSISSIPPI: IMPORTANT NOTICE ABOUT YOUR SERVICE CONTRACT COVERAGE
THIS INFORMATION AFFECTS YOUR LEGAL RIGHTS
READ THE FOLLOWING INFORMATION CAREFULLY
1. THE CONTRACT UNDER WHICH YOU ARE COVERED INCLUDES A DISPUTE RESOLUTION CONTRACT.
2. THE DISPUTE RESOLUTION CONTRACT REQUIRES THAT ANY DISPUTE RELATED TO YOUR COVERAGE
MUST BE RESOLVED BY ARBITRATION AND NOT IN A COURT OF LAW.
3. THE RESULTS OF THE ARBITRATION ARE FINAL AND BINDING ON YOU AND US.
4. IN AN ARBITRATION, ONE OR MORE ARBITRATORS, WHO ARE INDEPENDENT, NEUTRAL DECISION
MAKERS, RENDER A DECISION AFTER HEARING THE POSITIONS OF THE PARTIES.
5. WHEN YOU BECOME A CONTRACT HOLDER UNDER THIS CONTRACT YOU MUST RESOLVE ANY DISPUTE
RELATED TO THE CONTRACT BY BINDING ARBITRATION INSTEAD OF A TRIAL IN COURT, INCLUDING A
TRIAL BY JURY.
6. BINDING ARBITRATION GENERALLY TAKES THE PLACE OF RESOLVING DISPUTES BY A JUDGE AND JURY.
7. SHOULD YOU NEED ADDITIONAL INFORMATION REGARDING THE BINDING ARBITRATION PROVISION IN
THE CONTRACT, YOU MAY CONTACT OUR TOLL FREE ASSISTANCE LINE AT 877-635-3143.
N
O
SA
Missouri: The CANCELLATION OF CONTRACT section is amended to add the following: If We cancel the Contract, notice of such cancellation will be delivered to You
by registered mail fifteen (15) days prior to cancellation. The applicable free-look time period on this Contract shall only apply to the original Contract purchaser. A ten
percent (10%) penalty per month shall be added to a refund that is not made within thirty (30) days of return of this Contract to Us. The seventy-five dollar ($75)
cancellation fee is replaced with a fifty dollar ($50) cancellation fee.
Nebraska: The ARBITRATION section is deleted in its entirety and replaced with the following:
Any Claim or dispute in any way related to this Contract, by a person covered under this Contract against Us or Us against a person covered under this Contract, may
be resolved by arbitration only upon mutual consent of the parties. Arbitration pursuant to this provision shall be subject to the following:
a) no arbitrator shall have the authority to award punitive damages or attorney’s fees;
b)
neither party shall be entitled to arbitrate any claims or disputes in a representative capacity or as a member of a class; and
c)
no arbitrator shall have the authority, without the mutual consent of the parties, to consolidate claims or disputes in arbitration.
Nevada: The provisions of this Contract apply only to the original purchaser of the Contract.
CANCELLATION OF CONTRACT section is deleted in its entirety and replaced with the following: You may cancel this Contract by submitting a written request to the
Seller containing a copy of Your Contract and the current mileage on Your Vehicle. During the first sixty (60) days from the Contract Sale Date, We or the Seller will
refund You 100% of the Contract Sale Price with no deductions for any Claims or pending Claims. After the first sixty (60) days from the Contract Sale Date, We will
refund You a pro-rated amount of the purchase price of the Contract with no deductions for any Claims or pending Claims, less a twenty-five dollar ($25) cancellation
fee, within 45 days after the Contract has been returned to Us. A ten percent (10%) penalty per month shall be added to a refund that is not made within forty-five (45)
days of return of this Contract to Us.
We may cancel this Contract during the first sixty (60) days of the Contract Sale Date for any reason. After sixty (60) days, We may cancel this Contract for material
misrepresentation or fraud by You at time of sale or non payment of Contract Sale Price by You. If We cancel this Contract, We or the Seller will refund You 100% of
the Contract Sale Price. No Claims paid on Your Contract will ever be deducted from any refund issued pursuant to this Contract in Nevada. If We cancel this
Contract, no cancellation will become effective until at least fifteen (15) days after the notice of cancellation is mailed to You.
If Your Contract is financed, the lender has the right to receive any portion of the cancellation refund amounts. If Your Vehicle is repossessed, stolen or declared a
total loss, You authorize the lender to cancel this Contract. In either case, no cancellation will become effective until at least fifteen (15) days after the notice of
cancellation is mailed to You.
INELIGIBLE VEHICLES 2) is amended to add the following: This Contract may not be initially issued to any vehicle described in the INELIGIBLE VEHICLES section of
this Contract. However, the INELIGIBLE VEHICLES section does not apply if the manufacturer’s warranty on Your vehicle is cancelled at some time during the term of
this Contract once the Contract has already been issued to You.
This Contract is non-renewable.
If You use Your Vehicle in a manner not recommended by the manufacturer, this Contract will not cover any Breakdown that arises out of such specific nonmanufacturer-recommended uses. However, this Contract will continue to cover any Breakdown that is not related to the non-manufacturer-recommended uses of Your
Vehicle, unless such coverage is otherwise excluded by the terms of this Contract. If the manufacturer’s warranty on Your Vehicle becomes void for any reason during
the term of this Contract, We will not automatically suspend or void all coverage. We will not provide any coverage that would have otherwise been provided under the
manufacturer’s warranty. However, We will continue to provide any other coverage under this Contract, unless such coverage is otherwise excluded by the terms of this
Contract.
New Hampshire: If You have any questions regarding this Contract, You may contact Us by mail or by phone. Refer to the front of this Contract for Our address and
toll-free number. In the event You do not receive satisfaction under this Contract, You may contact the New Hampshire Insurance Department at the following address:
21 Fruit Street, Suite 14, Concord, New Hampshire 03301.
New Mexico: CANCELLATION OF CONTRACT section is revised to add the following:
No Contract that has been in effect for at least seventy (70) days will be cancelled by Us before the expiration of the agreed term or one (1) year after the Contract Sale
Date, whichever occurs first, except on any of the following grounds:
1. Your failure to pay an amount when due;
2. You are convicted of a crime that results in an increase in the service required under the Contract;
3. Discovery of fraud or material misrepresentation by You in obtaining the Contract or in presenting a Claim for service there under; or
4. Discovery of either of the following if it occurred after the Contract Sale Date and substantially and materially increased the service required under the Contract:
a. An act or omission by You; or b. Your violation of any condition of the Contract.
The right to void this Contract is not transferable and applies only to the original Contract Holder. If We cancel the Contract, notice of such cancellation will be
delivered to You by registered mail fifteen (15) days prior to cancellation. The notice of cancellation will state the reason for cancellation and will include any
reimbursement required. The cancellation will be effective as of the date of termination as stated in the notice of cancellation. A ten percent (10%) penalty per month
shall be added to a refund that is not made within thirty (30) days of return of this Contract to Us. The cancellation fee does not apply in New Mexico.
New York: CANCELLATION OF CONTRACT section is amended to add the following: If this Contract is originally delivered to You by mail, You may cancel this
Contract within thirty (30) days after the date the Contract was mailed to You and receive a full refund of the Contract Sale Price provided no Claim has been made
under the Contract. If a full refund is due to You under this Contract, a ten percent (10%) penalty per month will be added to the refund if it is not made within thirty (30)
days of return of the Contract to Us.
North Carolina: CANCELLATION OF CONTRACT section is amended as follows: A twenty-five dollar ($25) cancellation fee or ten percent (10%) of the pro-rata refund
amount, whichever is less, is applicable. We may only cancel this Contract for non-payment of premium or for a direct violation of the Contract by You.
Oklahoma: Oklahoma service warranty statutes do not apply to commercial use references in service warranty contracts.
Coverage afforded under this Contract is not guaranteed by the Oklahoma Insurance Guaranty Association.
Section D. SURCHARGES, Snow Plow section, is amended as follows: Installation of a snow plow that voids the original manufacturer warranty will make the coverage
provided under this Contract voidable.
Section D. SURCHARGES, Lift Kit/Tire Modifications section, is amended as follows: Any modification that voids the original manufacturer warranty will make the
coverage provided under this Contract voidable.
For towing service, contact Quest Towing Services at (855) 418-2338 or 106 West Tolles Drive, St. Johns, MI 48879.
The CANCELLATION OF CONTRACT section is deleted in its entirety and replaced with the following: You may cancel this Contract by submitting a written request to
the Seller containing a copy of Your Contract. If You cancel during the first sixty (60) days from the Contract Sale Date, and no Claim has been authorized or paid, We
or the Seller will refund You 100% of the Contract Sale Price. After the first sixty (60) days from the Contract Sale Date, or if a Claim was made within the first sixty (60)
days, We or the Seller shall provide a refund of ninety percent (90%) of the unearned pro rata premium. We may cancel this Contract during the first sixty (60) days of
the Contract Sale Date for any reason. After sixty (60) days, We may cancel this Contract for material misrepresentation or fraud at time of sale, non-payment of
Contract Sale Price, or if the Vehicle is determined to be ineligible for coverage under the INELIGIBLE VEHICLES section. If We cancel this Contract, We or the Seller
will refund You 100% of the Contract Sale Price. If Your Contract is financed, the lender has the right to receive any portion of the cancellation refund amounts. If Your
Vehicle is repossessed, stolen or declared a total loss, You authorize the lender to cancel this Contract.
ARBITRATION section is amended to add the following: While arbitration is mandatory, the outcome of any arbitration shall be non-binding on the parties, and either
party shall, following arbitration, have the right to reject the arbitration award and bring suit in district court.
Oregon: ARBITRATION section is amended to add the following: If Claim settlement cannot be reached, the parties may elect arbitration by mutual agreement at the
time of the dispute after the claimant has exhausted all internal appeals and can be binding by Your consent. Arbitration must occur in Oregon and according to Oregon
law.
South Carolina: If You have any questions regarding this Contract, or a complaint against Us, You may contact the South Carolina Department of Insurance at P.O.
Box 100105, Columbia, SC 29202, (803) 737-6160, [email protected].
FP1594
TX Lic. No. 640
7 of 8
(08/12)
N
O
SA
M
T
P
AC L
E
TI
VE
The CANCELLATION OF CONTRACT section is amended to add the following: A ten percent (10%) penalty per month shall be added to a refund that is not made within
forty-five (45) days of return of this Contract to Us.
Texas: If You have any questions regarding the regulation of this Contract or a complaint against Us, You may contact the Texas Department of Licensing and
Regulation at 920 Colorado, Austin, Texas 78701 or P.O. Box 12157, Austin, Texas 78711, (800) 803-9202. CANCELLATION OF CONTRACT section is amended to add
the following: A ten percent (10%) penalty per month shall be added to a refund that is not made within forty-five (45) days after return of the Contract to Us. If a covered
Claim is not paid within forty-five (45) days after You have filed proof of loss with Us, You may file a Claim directly with First Colonial Insurance Company at (800) 6214871; 1776 American Heritage Life Drive, Jacksonville, FL 32224. If We cancel this Contract for any reason other than non-payment of the Contract Sale Price or
material misrepresentation by You to Us, We shall mail a written notice of cancellation to You at the last known address before the fifth day preceding the effective date
of cancellation. The notice will state the effective date of cancellation and the reason for cancellation.
Utah: Coverage afforded under this Contract is not guaranteed by the Utah Property and Casualty Guaranty Association.
This Contract is subject to limited regulation by the Utah Insurance Department. To file a complaint, contact the Utah Insurance Department.
YOUR RESPONSIBILITIES IN CASE OF A BREAKDOWN, RENTAL, AND TOWING sections are amended to add the following: If You fail to give any notice or file any
proof of loss required by this Contract within the time specified in this Contract, it does not invalidate a Claim made by You if You show that it was not reasonably
possible to give the notice or file the proof of loss within the prescribed time and that notice was given or proof of loss was filed as soon as reasonably possible.
ARBITRATION section 3, is deleted in its entirety and replaced with the following: Any matter in dispute between You and Us may be subject to arbitration as an
alternative to court action pursuant to the rules of (The American Arbitration Association or other recognized arbitrator), a copy of which is available on request from Us.
Any decision reached by arbitration shall be binding upon both You and Us.
The arbitration award may include attorney’s fees, if allowed by state law, and may be entered as a judgment in any court of proper jurisdiction. The arbitrator shall be
prohibited from awarding punitive, consequential, special, incidental, and exemplary damages. The arbitrator may award a party only its actual damages and the
arbitrator may award equitable relief including injunctive relief. An arbitration award may not be set aside in later litigation except upon the limited circumstances set forth
in the Federal Arbitration Act, 9 U.S.C. §1 et. Seq. An award in arbitration will be enforceable under the Federal Arbitration Act by any court having jurisdiction.
CANCELLATION OF CONTRACT section is amended to add the following: If We cancel this Contract, We will provide written notice of cancellation, including the actual
reason for the cancellation, to the last known mailing address at least:
1. Ten (10) days before the effective date of cancellation if cancelled for non-payment of the Contract Sale Price;
2. Forty five (45) days before the effective date of cancellation if cancelled for any other reason.
Payment Terms: This Contract can be purchased by using Cash/Credit Card or Financed as part of Your vehicle loan.
YOUR RESPONSIBILITIES IN CASE OF A BREAKDOWN section has been revised to add the following: If an emergency occurs which requires a covered Breakdown
repair to be made at a time when Our office is closed and prior authorization for the repair cannot be obtained, You should follow all of the Claim procedures outlined in
this section with the exception of 5. Obtain Authorization for Payment from Us. After following these instructions, contact Us for Claims instructions on the next business
day at (877) 635-3143, or as soon as reasonably possible.
Washington: All references to Administrator throughout this Contract are replaced with Service Provider.
Our obligations under this Contract are guaranteed by a reimbursement insurance policy issued by First Colonial Insurance Company, Policy Number: PCS0008WA.
You may file a Claim directly with First Colonial Insurance Company at (800) 621-4871; 1776 American Heritage Life Drive, Jacksonville, FL 32224 at any time.
CANCELLATION OF CONTRACT section is deleted in its entirety and replaced with the following: You may cancel this Contract by submitting a written request to the
Seller stating the date upon which the cancellation is effective, and containing a copy of Your Contract and the current mileage on Your Vehicle. During the first sixty
(60) days from the Contract Sale Date, We or the Seller will refund You 100% of the Contract Sale Price, less any Claims paid on Your Contract. After the first sixty
(60) days from the Contract Sale Date, We or the Seller will refund You a pro-rated amount of the Contract Sale Price, based on the lesser of the months or miles
remaining, less a twenty five dollar ($25) cancellation fee. If You are the original Contract Holder and You cancel this Contract within sixty (60) days of the original
Contract Sale Date, a ten percent (10%) penalty per month shall be added to a refund that is not made within thirty (30) days of return of this Contract to Us.
We may cancel this Contract during the first sixty (60) days of the Contract Sale Date for any reason. After sixty (60) days, We may cancel this Contract for non
payment of Contract Sale Price by the Seller to Us, or for material misrepresentation or fraud at time of sale. If We cancel this Contract, We or the Seller will refund You
100% of the Contract Sale Price.
If We have notice of a lender and a Discharge of Lien is not provided, any refund will be issued to the lender. If Your Vehicle is repossessed, stolen or declared a total
loss, You authorize the lender on the Declarations Page to cancel this Contract. If cancelled, the Contract will not be reinstated.
ARBITRATION section is amended to add the following: The Insurance Commissioner of Washington is the Service Provider’s attorney to receive service of process in
any action, suit or proceeding in any court, and the state of Washington has jurisdiction of any civil action in connection with this Contract
West Virginia: The cancellation fee does not apply in West Virginia.
Section B. GENERAL PROVISIONS is amended as follows: If a covered Claim is not paid within fifteen (15) working days from the agreed upon settlement, You may file
a Claim directly with First Colonial Insurance Company at (800) 621-4871; 1776 American Heritage Life Drive, Jacksonville, FL 32224.
ARBITRATION section is amended to add the following: If both parties agree to arbitrate, each party will select an arbitrator. The two arbitrators will select a third
arbitrator. If they cannot agree upon the selection of a third arbitrator within thirty (30) days, both parties must request that selection of a third arbitrator be made by a
judge of a court having jurisdiction. Local rules of law as to procedure and evidence will apply. Payment of the arbitrator’s fee shall be made by Us if coverage is found to
exist. If coverage is not found, each party will: (a) pay its chosen arbitrator; and (b) bear the other expenses of the third arbitrator equally.
Wisconsin: THIS CONTRACT IS SUBJECT TO LIMITED REGULATION BY THE OFFICE OF THE COMMISSIONER OF INSURANCE.
The last bullet under B. GENERAL PROVISIONS is deleted in its entirety and replaced with the following: After You are made whole, Your rights of recovery from
anyone else becomes Ours up to the amount We have paid. You must protect these rights and help Us enforce them.
EXCLUSION 2(c) is hereby deleted in its entirety.
YOUR RESPONSIBILITIES IN CASE OF A BREAKDOWN 5. is revised to add the following: Failure to receive preauthorization will not cause Your Claim to be denied,
but You should contact the Us as soon as reasonably possible.
YOUR RESPONSIBILITIES IN CASE OF A BREAKDOWN 8. is deleted in its entirety and replaced with the following: To obtain payment for a covered Breakdown, You
or the Approved Repair Facility must submit a legible copy of the repair invoice to Us. Repair invoices must include the following: authorization number, Authorized
Amount, Your name, address, phone number and signature; repair facility name, address, and phone number; Vehicle Identification Number (VIN), Vehicle mileage and
repair date; Your description of the Breakdown and the repair facility’s description of the diagnosis and repair; part numbers, part descriptions and prices; labor hours,
labor descriptions, labor rate; and the total amount requested for payment. All documents pertaining to a Claim must be submitted to Us as soon as reasonably possible
and with one (1) year from the date of the covered Breakdown to be eligible for payment. Failure to provide receipts within this time period may result in the denial of
reimbursement. When submitting Your Claim for payment, send only photocopies of Your receipts. Keep the originals for Your records.
CANCELLATION OF CONTRACT is deleted in its entirety and replaced with the following:
You may cancel this Contract by submitting a written request to the Seller containing a copy of Your Contract and the current mileage on Your Vehicle. During the first
sixty (60) days from the Contract Sale Date, We or the Seller will refund You 100% of the Contract Sale Price with no deductions for any Claims or pending Claims.
After the first sixty (60) days from the Contract Sale Date, We or the Seller will refund You a pro-rated amount of the Contract Sale Price, based on the lesser of the
months or miles remaining, less a fifty dollar ($50) cancellation fee, with no deductions for any Claims or pending Claims.
We may cancel this Contract during the first sixty (60) days of the Contract Sale Date for any reason. After sixty (60) days, We may cancel this Contract for material
misrepresentation or fraud at time of sale, non payment of Contract Sale Price, or if the Vehicle is determined to be ineligible for coverage under the INELIGIBLE
VEHICLES section. If We cancel this Contract, We or the Seller will refund You 100% of the Contract Sale Price with no deductions for any Claims or pending Claims.
If Your Contract is financed, the lender has the right to receive any portion of the cancellation refund amounts. If Your Vehicle is repossessed, stolen or declared a total
loss, You authorize the lender to cancel this Contract.
APPROVED REPAIR FACILITY’S GUIDE TO FILING A CLAIM section is amended as follows: A Claim will not be denied for failure of the repair facility to submit
invoices to Us within ninety (90) days of the completion of the authorized repairs.
Wyoming: The CANCELLATION OF AGREEMENT section is amended to add the following: If You are the original Contract Holder and You cancel this Contract
within sixty (60) days of the original Contract Sale Date, a ten percent (10%) penalty per month shall be added to a refund that is not made within forty five (45) days of
return of this Contract to Us.
If We cancel this Contract, We will provide written notice of cancellation, including the effective date of the cancellation and the actual reason for the cancellation, to the
last known mailing address at least: Ten (10) days before the effective date of cancellation if cancelled for any reason other than non-payment of the Contract Sale Price;
a material misrepresentation by You to the provider; or a substantial breach of duties by You relating to the covered product or its use. ARBITRATION does not apply in
Wyoming.
FP1594
TX Lic. No. 640
8 of 8
(08/12)