Markel’s Electronic Record and Signature Agreement, Fair Credit Report Act Notice and Fraud Warnings
Fair Credit Report Act Notice: Personal information about you, including information from a credit or other investigative report, may be collected from persons other than you in connection with this application for insurance and subsequent amendments and renewals. Such information as well as other personal and privileged information collected by us or our agents may in certain circumstances be disclosed to third parties without your authorization. Credit scoring information may be used to help determine either your eligibility for insurance or the premium you will be charged. We may use a third party in connection with the development of your score. You may have the right to review your personal information in our files and request correction of any inaccuracies. You may also have the right to request in writing that we consider extraordinary life circumstances in connection with the development of your credit score. These rights may be limited in some states. Please contact your agent or broker to learn how these rights may apply in your state or for instructions on how to submit a request to us for a more detailed description of your rights and our practices regarding personal information.
Fraud Warning: Any person who knowingly and with intent to defraud any Insurance Company or another person files an application for insurance or statement of claim containing any materially false information, or conceals for the purpose of misleading information concerning any fact material thereto, commits a fraudulent insurance act, which is a crime and subjects the person to criminal and [NY: substantial] civil penalties. (Not applicable in AL, AR, CO, DC, FL, KS, KY, LA, MD, ME, NJ, NM, NY, OH, OK, OR, PA, RI, TN, VA, WA, VT, and WV) (insurance benefits may also be denied in LA, ME, TN, and VA.)
STATE FRAUD STATEMENTS
Applicable in AL, AR, DC, LA, NM, RI and WV
Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit or knowingly presents false information in an application for insurance is guilty of a crime and may be subject to fines and confinement in prison.
Applicable in CO
It is unlawful to knowingly provide false, incomplete, or misleading facts or information to an insurance company for the purpose of defrauding or attempting to defraud the company. Penalties may include imprisonment, fines, denial of insurance and civil damages. Any insurance company or agent of an insurance company who knowingly provides false, incomplete, or misleading facts or information to a policyholder or claimant for the purpose of defrauding or attempting to defraud the policyholder or claimant with regard to a settlement or award payable from insurance proceeds shall be reported to the Colorado Division of Insurance within the Department of Regulatory Agencies.
Applicable in FL and OK
Any person who knowingly and with intent to injure, defraud, or deceive any insurer files a statement of claim or an application containing any false, incomplete, or misleading information is guilty of a felony (of the third degree)*. *Applies in FL Only.
Applicable in KS
Any person who, knowingly and with intent to defraud, presents, causes to be presented or prepares with knowledge or belief that it will be presented to or by an insurer, purported insurer, broker or any agent thereof, any written, electronic, electronic impulse, facsimile, magnetic, oral, or telephonic communication or statement as part of, or in support of, an application for the issuance of, or the rating of an insurance policy for personal or commercial insurance, or a claim for payment or other benefit pursuant to an insurance policy for commercial or personal insurance which such person knows to contain materially false information concerning any fact material thereto; or conceals, for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act.
Applicable in KY, NY, OH and PA
Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or statement of claim containing any materially false information or conceals for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act, which is a crime and subjects such person to criminal and civil penalties* (not to exceed five thousand dollars and the stated value of the claim for each such violation)*. *Applies in NY Only.
Applicable in ME, TN, VA and WA
It is a crime to knowingly provide false, incomplete or misleading information to an insurance company for the purpose of defrauding the company. Penalties (may)* include imprisonment, fines and denial of insurance benefits. *Applies in ME Only.
Applicable in MD
Any person who knowingly or willfully presents a false or fraudulent claim for payment of a loss or benefit or who knowingly or willfully presents false information in an application for insurance is guilty of a crime and may be subject to fines and confinement in prison.
Applicable in NJ
Any person who includes any false or misleading information on an application for an insurance policy is subject to criminal and civil penalties.
Applicable in OR
Any person who knowingly and with intent to defraud or solicit another to defraud the insurer by submitting an application containing a false statement as to any material fact may be violating state law.
Applicable in VT
Any person who knowingly presents a false statement in an application for insurance may be guilty of a criminal offense and subject to penalties under state law.
Markel Corporation Electronic Record and Signature Agreement
Markel Corporation, its subsidiaries and affiliates (collectively: “Markel”), may be required to provide you, your organization, or your representatives certain notices, disclosures, documents, policies, and/or related materials (collectively: “Insurance Documents”) as part of an actual or proposed insurance transaction; and, further, may need to obtain signed copies of Insurance Documents from you in order to facilitate an actual or proposed insurance transaction, confirm your receipt of such materials, or facilitate the servicing of insurance products purchased from Markel. Accordingly, by clicking the “I Agree” button at the bottom of this document, you agree to receive Insurance Documents electronically and provide electronic signatures in lieu of physical signatures (collectively: “Conduct Business Electronically”), where such electronic business functionality is made available by Markel or its designated service provider(s), and to do so upon such terms and conditions as are outlined below or as may be amended by Markel and/or its service provider(s) from time to time.
Obtaining Paper Copies
You or your authorized representative may request paper copies of any and all Insurance Documents provided or made available to you electronically by Markel. Markel hereby agrees to provide such paper copies, free of charge, and to arrange for delivery via the US Postal Service or a nationally established private carrier service, with such materials to be posted to the mailing address associated with your account. Requests for paper copies of Insurance Documents must include the relevant insured name, address, policy number, and effective dates and be signed by an insured or their authorized representative. Such requests should be directed to one of the following:
Mailing Address: Markel Corporation
P.O. Box 3009
Omaha, NE 68103
E-mail: markelesign@MarkelCorp.com
Withdrawing your Consent
You may elect to withdraw your consent to Conduct Business Electronically at any time and without penalty, provided that such withdrawal is made in writing and includes the relevant insured name, address, policy number, and policy effective date and is signed by you or your authorized representative. Markel will process all properly filed withdrawals in a timely manner; but reserves the right to continue to continue to Conduct Business Electronically during the pendency of such withdrawal of consent, as Insurance Documents and related signatures may be time sensitive and circumstances may not allow for manual exchange of hard-copy documents. Withdrawal requests should be directed to of the following:
Mailing Address: Markel Corporation
P.O. Box 3009
Omaha, NE 68103
E-mail: markelesign@MarkelCorp.com
Electronic Delivery and Signature Vendors
Markel may utilize the services of third-party service providers to facilitate electronic delivery of Insurance Documents and/or provide for electronic signature of such materials. Accordingly, your agreement to Conduct Business Electronically is also contingent upon your agreement to such further terms and conditions, including any hardware and software requirements, as may be required of Markel’s various service providers. Furthermore, you expressly acknowledge and agree that any action or failure to act on the part of such service provider(s) shall not give rise to any cause of action, suit, claim for damages, or similar proceedings against Markel.
Electronic Contact Information
In order to Conduct Business Electronically, you will be required to provide Markel and its service providers with your e-mail address and, in doing so, agree that neither Markel nor its service providers have any obligation to provide for the ongoing validation of such e-mail address. Accordingly, you are responsible for advising Markel and its service providers of any changes to your e-mail address by utilizing the process outlined by such service provider. Markel must be notified of e-mail address changes by directing correspondence to one of the following:
Mailing Address: Markel Corporation
P.O. Box 3009
Omaha, NE 68103
Toll-Free Telephone: 888-500-3344
E-mail: markelesign@MarkelCorp.com
Document Access, Retention, or Content Errors
During the course of Conducting Business Electronically you will receive electronic copies of documents, some of which may require your electronic signature, and all of which should be maintained in printed or electronic form for your records. Upon receiving such documents, or during your review thereof, instances may arise in which you are unable to access, save, or print copies of such documents. Similarly, you may identify errors in the content of such documents, which require correction. Should any of these circumstances arise, please contact Markel immediately via one of the following methods:
Mailing Address: Markel Corporation
P.O. Box 3009
Omaha, NE 68103
Toll-Free Telephone: 888-500-3344
E-mail: markelesign@MarkelCorp.com
Acknowledgement
By clicking the the Purchase button, you expressly acknowledge and agree that you have read Markel’s Electronic Record and Signature Agreement and the terms and conditions contained herein; and that you were able to print on paper or electronically save and subsequently access Markel’s Electronic Record and Signature Agreement document and any associated materials incorporated herein by reference, including those documents referenced on the attached Certificate of Completion and the Certificate of Completion itself.
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