Agreement for Advanced Insurance Management®
Review of Workers' Compensation Premiums
- Advanced Insurance Management LLC ("A.I.M.") agrees to review Client’s current
and prior Workers’ Compensation insurance policies and premiums
(collectively referred to as "WC Premiums") to find premium reduction(s),
credit(s), premium adjustment(s), overcharges, and/or refund(s)
(collectively referred to as "Savings") caused by mistakes in use of
classification codes, payroll calculation, Experience Modification Factor
computation, and/or other technical factor affecting such premiums. A.I.M.
does not guarantee that it will find Savings. All information obtained by AI.M.
about Client and Client’s operations shall be treated as confidential
information and shall be used by A.I.M. solely in its efforts to produce
Workers’ Compensation premium savings. Illinois law governs this agreement.
- _____________________________________ ("Client") agrees to provide
copies to A.I.M., of insurance policies, audits, and related insurance work
papers and to request needed materials from insurance companies, agents,
and/or rating bureaus, subject to availability, as well as to provide
reasonable information about Client’s operations that affect its WC Premiums.
Client authorizes A.I.M. to work with Client’s insurance companies, insurance
rating organizations, and insurance regulatory agencies to correct any
overcharges A.I.M. finds.
- Client may cancel this agreement by providing written notification to
A.I.M. at any time. However, Client is obligated to pay A.I.M. per the
terms of this agreement for any Savings identified by A.I.M. and
communicated to Client or to Client's insurers or to insurance rating
bureaus prior to such cancellation, if Client subsequently receives such
Savings due to the efforts of A.I.M.
- A.I.M. agrees that it will suspend or discontinue its efforts to obtain
Savings for Client if Client so instructs A.I.M. in writing.
Client shall pay A.I.M. as follows:
- If A.I.M. produces no Savings that benefit Client on its WC Premiums,
A.I.M. charges nothing for its services. Only Savings due to A.I.M.’s
efforts, advice, recommendation, and/or assistance (collectively referred
to as "Help" or "Helps") shall be considered in computing any fee due.
- If Client realizes Savings for the Current Policy and/or prior policies
due to A.I.M.’s Help, Client agrees to pay, to A.I.M., a fee equal to 50% of
such Savings. Such Savings must be realized without reducing Client’s
Workers’ Compensation coverage. Such Savings must also be of a nature that
the Client would not have received them without the help of A.I.M. "Current
policy" is defined as the policy in effect on the date this agreement is
signed. Any Savings on future policies due to the help of A.I.M. generate no
fee for A.I.M.
- Fees for services are due A.I.M. only when Savings are actually received.
Such fee is due and payable to A.I.M. upon receipt of the Savings. If payment
of such fee is not received by A.I.M. within 15 days of Client’s receipt of
such Savings, A.I.M. is entitled to add to its fee a late charge of .05% per
day of the outstanding fee owed.
- A copy hereof received by facsimile transmission and bearing one or more
signatures shall be deemed to be an original.
By signing below, the parties acknowledge that they have read and understood
the above terms.
Client Company Executive Officer Signature
For Advanced Insurance Management LLC_______________________________________
© 2006 Advanced Insurance