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- Policy Number
- Names, contact phone number for all involved parties and witnesses
- Date, location, and time of loss
- Any police, fire, or other authorities involved or who responded
- Description of damage
- How the loss occurred
TERMS OF SERVICE AGREEMENT
Welcome to the Continental Western Group® E-Pay Express online bill payment services website, which provides bill payment options and services (such website, options, and services are individually and collectively referred to herein as the “E-Pay Express Services”) available to customers of the Continental Western Group®, an operating unit of Berkley Insurance Company, and affiliated companies (referred to herein as “OU acronym, i.e. “CWG”). CWG® is willing to provide the E-Pay Express Services to you, a customer of CWG, only upon your agreement that your access to and use of the E-Pay Express Services will be subject to the following E-Pay Express Terms of Service Agreement (the “Agreement”). This Agreement describes the terms and conditions under which CWG will make E-Pay Express Services available to CWG’s customers (“you”). The Agreement may be revised without notice and will become effective upon posting on this site and your use of the E-Pay Express Services.I. DEFINITIONSThe following defined terms are used in this Agreement: E-Pay Express is a service you can use to view and pay your CWG bill online securely. CWG has licensed the right to use E-Pay Express from an unaffiliated third party, Fifth Third Bank. and/or its affiliates (“Fifth Third”). Account means the Account with CWG to which you authorize a bill payment to be directed. Payment Instruction means your instruction and authorization to E-Pay Express to make a bill payment to your Account. Payment Account means the bank account that you authorize E-Pay Express to debit when you make your bill payment using account information from your personal or business checking or savings account. Payment Card means the credit or debit card that you instruct E-Pay Express to charge to pay your bill payment. Business Day means Monday through Friday, excluding Federal Reserve holidays. Scheduled Payment Date means the Business Day of your choice upon which E-Pay Express will attempt to complete your bill payment and initiate the appropriate debit to your Payment Account or Payment Card. CWG includes the following affiliated companies of Berkley Insurance Company: Acadia Insurance Company, Continental Western Insurance Company, Firemen’s Insurance Company of Washington, D.C., Tri-State Insurance Company of Minnesota, Union Insurance Company (collectively referred to herein as “Insurers”). All payments processed through E-Pay Express Services are paid to CWG on behalf of itself or one of the Insurers listed above; however, each of the Insurers has sole financial responsibility for its own products and services, including the E-Pay Express Services provided in connection with those products and services. You should refer to your insurance policy for the applicable Insurer.II. DESCRIPTION OF E-PAY EXPRESS SERVICES A. The E-Pay Express Services provide you with access to various online resources, including applications that allow you to view your CWG bill. Unless explicitly stated otherwise, any new features that augment or enhance the current E-Pay Express Services, including the release of new services, shall be subject to this Agreement. Upon your acceptance of this Agreement, CWG grants you a personal, nonexclusive, non-transferable license to access and use the E-Pay Express Services, subject to this Agreement, solely for the purpose of viewing and paying your Account electronically. The foregoing license includes the specific rights to use the available applications and functionalities of the E-Pay Express Services and to print information from the E-Pay Express Services. CWG and Fifth Third do, however, reserve the right to, without notice: (a) modify, suspend or terminate operation of or access to the E-Pay Express Services at any time for any reason; (b) modify or change the E-Pay Express Services or its applicable operating policies at any time; and (c) interrupt the E-Pay Express Services as necessary to perform routine and non-routine maintenance, error corrections, or other changes. CWG also reserves the right to modify this Agreement at any time, in which case you will be provided notice that the Agreement has been changed. Your continued use of the E-Pay Express Services after said notice of the changed Agreement constitutes your agreement with and acceptance of the changed Agreement.
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- BILL PAYMENT SERVICE
- Sufficient funds are not available through your Payment Account or your Payment Card;
- Any failure on the part of CWG or Fifth Third to account correctly for or credit the payment in a timely manner, or any other mishandling of your payment by CWG or Fifth Third;
- The E-Pay Express Services are not working properly and you know or have been advised by CWG or Fifth Third about the malfunction before you execute the transaction;
- You do not provide CWG or Fifth Third with all required information to complete the bill payment, such as your correct name, telephone number, or your complete and correct Payment Card or Payment Account information; or
- Circumstances over which CWG or Fifth Third have no control include, but are not limited to, large-scale technical malfunctions, including, but not limited to, loss of access to the Internet or loss of access to the Federal Reserve System, prolonged outages of telephone lines, electricity or similar infrastructure, acts of God, war, riot, civil disobedience or similar events of insurrection, governmental or court orders, regulatory or legislative changes by any local, state or federal governmental agency, strikes, work stoppages or other similar occurrences or circumstances.
- any and all information that you provide to CWG or Fifth Third to use the E-Pay Express Services will be accurate and complete;
- you will not use the E-Pay Express Services to access information about any account unless you have authority to do so by the person or company whose account you are accessing;
- you will not provide any information to CWG or Fifth Third or in your use of the E-Pay Express Services, including account information unless you have the authority to communicate such information;
- you will not use the E-Pay Express Services for any illegal or improper purposes;
- you will not use: (i) any robot, spider, other automatic device to monitor or copy portions of the E-Pay Express home page or the E-Pay Express Services or the content contained therein, or (ii) any device, software, or routine to interfere or attempt to interfere with the proper working of the Payer Express home page or the E-Pay Express Services;
- you will not download, reproduce, duplicate, copy or otherwise extract any portion of the E-Pay Express home page or the E-Pay Express Services for the purpose of sale or resale, or make other commercial use thereof, and
- CWG or Fifth Third may send you electronic correspondence describing changes to the E-Pay Express Services and this Agreement.
Traditional Plans | Description | Amount Due on Effective Date (Month 1) | Additional Payments |
Full Pay | One payment | 100% | None |
Two Pay (Due Months 1 & 5) | Two equal payments | 50% | 50% |
Four Pay (Due Months 1, 3, 6, 9) | Four equal payments | 25% | 25% |
Monthly Pay (Due Months 1-11) | 20% first month, followed by 10 monthly payments | 20% | 8% |
I have read and agree to the following Terms of Service Agreement.
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- Abbreviation: WY
- Agency of Oversite: Wyoming Department of Workforce Services Workers’ Compensation Division
- Posting Notice: Certificate of Good Standing Required
- Addional Posting Information: Any business conducting work in the State of Wyoming or hiring a Wyoming resident as an employee must register with the Division of Workers’ Compensation and Unemployment Insurance.
- WC Info/Poster: https://cogs.wyo.gov/
- State Forms: http://wyomingworkforce.org/_docs/wc/Wyoming-Report-of-Injury-form.pdf
- Abbreviation: WI
- Agency of Oversite: Wisconsin Workers Compensation Division
- Posting Notice: No Poster Required
- Addional Posting Information: There is currently no requirement for the posting of a workers compensation insurance notice by the state of Wisconsin.
- WC Info/Poster: https://dwd.wisconsin.gov/wc/
- State Forms: https://dwd.wisconsin.gov/wc/about-us/formsorder.htm
- Abbreviation: SD
- Agency of Oversite: South Dakota Department of Labor and Regulation
- Posting Notice: Workplace Poster Required
- Addional Posting Information: Workers’ compensation law requires employers to post information encouraging safety.
- WC Info/Poster: https://dlr.sd.gov/employment_laws/posting_requirements.aspx
- State Forms: https://www.state.sd.us/eforms/secure/eforms/E1830V2-WCFRI.pdf
- Abbreviation: ND
- Agency of Oversite: North Dakota Workforce Safety And Insurance
- Posting Notice: Workplace Poster Required
- Addional Posting Information: n/a
- WC Info/Poster: https://www.workforcesafety.com/sites/www/files/documents/employers/resources/ImportantNoticetoWorkers_2019_BW_FINALMay%20162019.pdf
- State Forms: https://www.workforcesafety.com/WSI/OFROI/
- Abbreviation: NE
- Agency of Oversite: Nebraska Workers Compensation Court
- Posting Notice: No Poster Required
- Addional Posting Information: There is currently no requirement for the posting of a workers compensation insurance notice by the state of Nebraska.
- WC Info/Poster: https://doi.nebraska.gov/consumer/workers-compensation
- State Forms: https://doi.nebraska.gov/consumer/workers-compensation
- Abbreviation: MO
- Agency of Oversite: Missouri Division of Workers Compensation 2
- Posting Notice: Workplace Poster Required
- Addional Posting Information: The forms are mandatory in both English and Spanish. The forms must be posted proximately to each other. The forms are also available in two sizes—poster and letter size.
- WC Info/Poster: https://labor.mo.gov/posters
- State Forms: https://labor.mo.gov/dwc
- Abbreviation: MN
- Agency of Oversite: Minnesota Workers Compensation Division 1
- Posting Notice: Workplace Poster Required
- Addional Posting Information: n/a
- WC Info/Poster: https://www.dli.mn.gov/about-department/workplace-posters
- State Forms: https://www.dli.mn.gov/business/workers-compensation/work-comp-forms
- Abbreviation: MI
- Agency of Oversite: Michigan Workers Compensation Agency
- Posting Notice: No Poster Required
- Addional Posting Information: There is currently no requirement for the posting of a workers compensation insurance notice by the state of Michigan. But there are two posters that an employer may voluntarily post in the workplace.
- WC Info/Poster: https://www.michigan.gov/documents/wca/wca_WC-PUB-006_338137_7.pdf
- State Forms: https://www.michigan.gov/documents/wca_WC-100__fillin_121830_7.pdf
- Abbreviation: KS
- Agency of Oversite: Kansas Department of Labor, Division of Workers Compensation
- Posting Notice: Workplace Poster Required
- Additional Posting Information: Applicable to all accidents occurring on or after April 25, 2013.
- WC Info/Poster: https://dol.ks.gov/documents
- State Forms: https://www.dol.ks.gov/wc
- Abbreviation: IN
- Agency of Oversite: Indiana Workers Compensation Board
- Posting Notice: Workplace Poster Required
- Addional Posting Information: Employers of exempt employees who opt in to coverage under the Act must post notice SF 36097.
- WC Info/Poster: https://www.in.gov/wcb/2331.htm
- State Forms: https://www.in.gov/wcb/2339.htm
- Abbreviation: IL
- Agency of Oversite: Illinois Workers Compensation Commission
- Posting Notice: Workplace Poster Required
- Addional Posting Information: n/a
- WC Info/Poster: https://www2.illinois.gov/sites/iwcc/Documents/icpnFORM.pdf
- State Forms: https://www2.illinois.gov/sites/iwcc/resources/Pages/forms.aspx
- Abbreviation: CO
- Agency of Oversite: Colorado Division of Workers Compensation
- Posting Notice: Workplace Poster Required
- Addional Posting Information: Employers are required to display insurance posting notices along with the Notice to Employer of Injury poster.
- WC Info/Poster: https://cdle.colorado.gov/resources/forms
- State Forms: https://cdle.colorado.gov/resources/forms
- Please Note: Colorado Form WC 50 requires the name of your Insurer to be included on the Form prior to posting at your location(s). You can locate the name of your Insurer here on your policy.
- Abbreviation: IA
- Agency of Oversite: Iowa Division of Workers Compensation
- Posting Notice: No Poster Required
- Addional Posting Information: There is no posting notice requirement for employers that have secured workers compensation coverage or qualified as a selfinsurer. Only employers who have failed to secure coverage for the liabilities assumed under the Act must post a notice of the failure to insure.
- WC Info/Poster: https://www.iowaworkcomp.gov/brochure/2020-21
- State Forms: https://www.iowaworkcomp.gov/forms