Attorney Agreement

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<p>N E T W O R K AT T O R N E Y A P P L I C AT I O N G U I D E</p> <p>Jumpstart Your Marketing Program</p> <p>Join ARAGs Nationwide Attorney Network</p> <p>A Smart Marketing Tool for AttorneysN E T W O R K AT TO R N E Y A P P L I C AT I O N G U I D E</p> <p>Savvy attorneys recognize the power of marketing as a necessary tool to grow their business. Make a smart investment of your time and let ARAG market your practice on your behalf. Join the ARAG Attorney Network and we can help you create a channel of qualified leads and convert them into new clients. So, how does legal insurance work? Legal insurance provides quality, affordable and accessible resources to help members resolve everyday legal matters. Legal insurance is based on a traditional healthcare PPO model. Members choose an attorney from an experienced network base.</p> <p>The ARAG Attorney Network consists of an established community of more than 6,700 attorneys nationwide who provide consultation, document review, representation and preparation for covered legal matters. You will have the flexibility to choose areas of practice which provides you with greater control over client workload.</p> <p>Our ARAG Attorney was absolutely indispensable in the purchase of our home. He gave us expert and timely advice, and stood up for us. I hold him in high regard. Christophe E. Oak Park, IL 4-year ARAG member</p> <p>ARAG NETWORK ATTORNEYS ARE KEY TO MEMBER SATISFACTION</p> <p>ARAG Network Attorneys benefit from a smart and trusted business model for attracting new clients which can accelerate revenue and meet growth objectives. Since ARAG aggressively markets our legal plan as a voluntary benefit plan through employer and wholesale channels, youll have an excellent opportunity to establish and increase visibility of your practice areas within tightly networked corporate communities (including Fortune 500 companies) where word-of-mouth can fuel continuous referrals.S Enhanced Business Development: Your contact</p> <p>A Smart Business Model</p> <p>S Qualified Clients: Our award-winning Customer</p> <p>S Guaranteed Payment: You can view plan</p> <p>Care Center and web site resources educate and prepare clients on what to expect when working with a Network Attorney. descriptions and fee schedules before service is rendered. Average payment turnaround time is 10 business days after receipt of completed claim form. Electronic Funds Transfer (EFT) is available for faster payment. web site was developed to answer payment and coverage questions. The ARAG Forum is a virtual meeting place for you to exchange ideas, discuss recent legal news and dialogue with the ARAG Network Attorney community and ARAG Faculty.</p> <p>S Build a Nationwide Network: Our Attorney Network</p> <p>information and areas of practice will be available to members 24/7 through our online Attorney Finder. Meanwhile, our Customer Care Specialists will match member needs with your areas of practice.</p> <p>Trusted Resources</p> <p>S ARAG Provider Relations Team is led by attorneys, and dedicated</p> <p>S ARAG Attorney Network Web Site provides access to ARAGs Case</p> <p>to providing ongoing communications and support, that will help you increase client referrals, stay on top of legal trends and offer the efficiency of ARAG case management.</p> <p>WHATS REQUIRED TO JOIN THE NETWORK?</p> <p>S Agree to the terms of the ARAG Network Attorney Agreement S Agree to provide plan members with the covered services indicated on your Attorney Application at the rates described in ARAGs Fee Schedule S Be licensed to practice in the state where you accept clients and in good standing with the relevant regulatory authority</p> <p>Management System for tracking new and existing plan member status; as well as for customized attorney reports which show the number and names of plan members served, services billed and payment history. Additional resources include a collection of legal articles submitted by ARAG Network Attorneys and Faculty, FAQs and links to web sites that contain helpful information on basic law, case law, statutes, government materials and specialty information.</p> <p>ARAG is a global leader of legal insurance. Our international presence protects 15.5 million people in 13 countries and has a total annual premium base of $1.75 billion. ARAG Insurance Company is rated A (Excellent by A.M. Best Company).S Privately owned company</p> <p>About ARAG</p> <p>S Maintain a physical office in the state(s) where licensed and practicing law S Maintain malpractice insurance coverages of at least $100,000 per incident and $300,000 aggregate per year</p> <p>ARAG Quick Facts</p> <p>S Pioneered the legal insurance category S More than 70 years of experience S ARAG is an acronym for a German phrase that means</p> <p>general legal expense insurance</p> <p>Some of the Most Successful Organizations Partner with ARAG</p> <p>ARAG Global Headquarters 866-ARAGLAW (866-272-4529) S</p> <p>ARAG Network Attorney ApplicationSteps to Apply to the ARAG Attorney Network:</p> <p>1. Review the ARAG Network Attorney Agreement (found at By signing this application you will agree to the terms of the Attorney Network Agreement. 2. Complete and sign this ARAG Network Attorney Application. 3. Attach a completed IRS W-9 form for the attorney/firm entity that will receive payment. Form can be found at: 5. Return completed application and all attachments to (choose one): S Fax: 515-246-8710, ARAG, Attn: Provider Relations S E-mail scanned documents to: S Mail to: ARAG, Attn: Provider Relations, P.O. Box 93180, Des Moines, IA 50393-3180</p> <p>4. Attach a current copy of the Declaration page of your liability insurance policy, which specifies policy limits and expiration date.</p> <p>SECTION I Attorney Contact Information Please fill out the following information as you wish it to appear in the ARAG Attorney Finder Database.FIRST NAME M.I. LAST NAME</p> <p>SUFFIX</p> <p>FIRM NAME E-MAIL ADDRESS ADDRESS LINE 1 (STREET NAME, NO P.O. BOX) ADDRESS LINE 2 (STE, APT. NUMBER, NO P.O. BOX) CITY ZIP PHONE NUMBER FAX NUMBER COUNTY STATE WEB SITE URL OFFICE HOURS :</p> <p>AM PM</p> <p>TO NO</p> <p>AVAILABLE AFTER HOURS (CHECK ONE) YES</p> <p>:</p> <p>AM PM</p> <p>IS YOUR OFFICE ACCESSIBLE FOR DISABLED PERSONS? (CHECK ONE) PROXIMITY TO PUBLIC TRANSPORTATION (NO. OF BLOCKS) DO YOU HAVE AN ADDITIONAL OFFICE LOCATION? (CHECK ONE) YES NO YES NO</p> <p>CITY</p> <p>ARE YOU CERTIFIED AS A MINORITY BUSINESS ENTERPRISE (MBE) or WOMAN BUSINESS ENTERPRISE (WBE) (OPTIONAL)? YES, I AM MBE or WBE certified Please list: STATE COUNTY</p> <p>If answered yes above, please include address, phone and fax information for up to 3 additional office locations on separate letterhead. ARAG Network Attorneys need to maintain presence at each office location 20% of the standard work week in order to participate in the Attorney Network.</p> <p>NO, I am not MBE or WBE certified050907_v4 2010 ARAG North America, Inc.</p> <p>866-272-4529, ext. 3 S</p> <p>1</p> <p>ARAG Network Attorney ApplicationSECTION I Attorney Contact Information, continuedGENDER (OPTIONAL) (CHECK ONE): FEMALE MALE</p> <p>ETHNIC BACKGROUND (OPTIONAL) (CHECK ONE): AFRICAN AMERICAN OTHER (PLEASE LIST) ASIAN</p> <p>CAUCASIAN</p> <p>HISPANIC</p> <p>LANGUAGE(S) (OTHER THAN ENGLISH) IN WHICH YOU ARE FLUENT?</p> <p>HOW DID YOU HEAR ABOUT ARAG? (CHECK ALL THAT APPLY) ONLINE/WEB SITE PLEASE DETAIL ADVERTISEMENT TRADESHOW/CLE COLLEAGUE</p> <p>OTHER</p> <p>CLIENT/MEMBER</p> <p>E-MAIL</p> <p>LETTER</p> <p>DO YOU CURRENTLY WORK WITH OTHER LEGAL SERVICE PROVIDERS? IF YES, PLEASE LIST PROVIDERS</p> <p>YES</p> <p>NO</p> <p>SECTION II Practice InformationLAW SCHOOL (LIST SCHOOL NAME)</p> <p>DATE GRADUATED (mm/dd/yyyy)</p> <p>STATE(S) AND DATE (mm/dd/yyyy) ACTIVELY ADMITTED TO BAR</p> <p>BAR LICENSE NUMBER</p> <p>SECTION III Disclosures If you answer yes to any of the items below please complete and submit the Disclosure Questionnaire found at NO NO YES YES YES</p> <p>HAVE ANY COMPLAINTS BEEN FILED AGAINST YOU WITH ANY STATE BAR AND/OR DISCIPLINARY AUTHORITY? (CHECK ONE) HAVE ANY LEGAL ACTIONS BEEN FILED AGAINST YOU FOR PROFESSIONAL LIABILITY? (CHECK ONE) HAVE YOU BEEN CONVICTED OF ANY CHARGE INVOLVING FRAUD AND/OR FELONY? (CHECK ONE)</p> <p>050907_v4 2010 ARAG North America, Inc.</p> <p>2 866-272-4529, ext. 3 S</p> <p>ARAG Network Attorney ApplicationSECTION IV Areas of Practice &amp; Rate Information</p> <p>Please review and place a check to the LEFT of ALL areas of law which you are willing to accept. When selecting an area of law, you are agreeing to accept ARAG's Fee Schedule for covered matters and a reduction off your normal hourly rate for non-covered matters. You will indicate the amount of reduction below the areas of law selection table. Attorneys can access ARAGs Fee Schedule by contacting a Provider Relations Specialist at 866-272-4529, ext. 3. FAMILYAdministrative - Immigration Domestic Violence Criminal - Misdemeanor</p> <p>Administrative - School Issues</p> <p>Administrative - Social Security, Medicaid, Veterans Adoption Divorce/Separation/Annulment Contested Divorce/Separation/Annulment Uncontested</p> <p>Guardianship/Conservatorship Proceedings Name Change Post Decree</p> <p>Juvenile Court Proceedings Civil Matters Wills</p> <p>Insanity or Infirmity Proceedings Estate Administration &amp; Estate Closing Trusts</p> <p>Prenuptial/Postnuptial Agreement Criminal - Expungement</p> <p>Criminal - Defense of Felony Charges Criminal - Habeas Corpus Proceedings</p> <p>Elder Law</p> <p>FINANCES</p> <p>Administrative - State and Local Tax Bankruptcy - Chapter 13 Bankruptcy - Chapter 7</p> <p>IRS Audit Protection</p> <p>IRS Collection Defense</p> <p>Consumer Protection - Plaintiff Credit Report/Rating Dispute Debt Collection Defense</p> <p>Consumer Protection - Defendant</p> <p>HOME</p> <p>Administrative - Zoning Variances and/or Building Codes Landlord/Tenant</p> <p>Neighbor Dispute</p> <p>Personal Property Disputes Purchase/Sale Home</p> <p>Real Estate Dispute Refinance</p> <p>AUTO</p> <p>Traffic - Administrative Motor Vehicles Traffic - Driving Privilege Protection</p> <p>Traffic - Defense of Driving Under the Influence</p> <p>Traffic - Minor Traffic Offenses</p> <p>MISCELLANEOUSBusiness Matters</p> <p>Administrative - Other</p> <p>Contingent Fee/Plaintiff</p> <p>Specific Document Preparation</p> <p>Attorney Rate Information My normal hourly rate is $YES NO</p> <p>Do you wish to have rate information published in the ARAG Attorney Finder Database? (CHECK ONE) For non-covered matters, the percentage reduction to my normal hourly rate is: 25% 30% 33% 40%</p> <p>Other (list to the right, no less than 25%):</p> <p>%</p> <p>050907_v4 2010 ARAG North America, Inc.</p> <p>3 866-272-4529, ext. 3 S</p> <p>ARAG Network Attorney ApplicationSECTION V Payment Options</p> <p>Payment will be made as indicated on your W-9 Form. Choose ONE payment method below. If a payment method is not chosen, payment will be made by paper check.1. DIRECT DEPOSIT AUTHORIZATION</p> <p>TYPE OF ACCOUNT (CHOOSE ONE): SAVINGS ACCOUNT CHECKING ACCOUNT NAME ON ACCOUNT FINANCIAL INSTITUTION NAME ROUTING/TRANSIT NUMBER</p> <p>Complete this section if you wish to have claim payments directly deposited into your bank account via electronic funds transfer (EFT).</p> <p>ACCOUNT NUMBER</p> <p>OR 2.</p> <p>PAPER CHECK</p> <p>SECTION VI Acceptance of Terms</p> <p>I agree to maintain professional liability insurance (of no less than $100,000 per incident and $300,000 aggregate per year) as long as I remain on the ARAG Attorney Network. The information contained within this application is accurate. I understand if any of the information in this application changes, I will notify ARAG. I agree to be bound by the terms of the ARAG Attorney Agreement, Attorney Reimbursement Fee Schedule, Plan Descriptions and Exclusions and any subsequent revisions of any of the above. I understand each of these documents can be made available to me by contacting ARAG Provider Relations at: 866-272-4529, ext. 3. If I choose Direct Deposit Authorization in Section V, my signature below confirms authorization for ARAG, GuideOne Mutual Insurance Company and/or GuideOne Specialty Mutual Insurance Company (collectively, Company) to initiate electronic credit entries to my account for payment of claims. Should the Company enter more money into my account than I am entitled to receive, I authorize the Company to withhold such amount from a further credit entry. This authority will remain in effect until I notify ARAG of a change in my account or cancel it in writing.</p> <p>APPLICANTS SIGNATURE</p> <p>050907_v4 2010 ARAG North America, Inc.</p> <p>DATE:</p> <p>866-272-4529, ext. 3 S</p> <p>4</p> <p>ARAG P.O. Box 93180 Des Moines, IA 50393-3180 866-ARAGLAW 866-272-4529 515-246-8710 Fax</p> <p></p> <p>Frequently Asked QuestionsWhy should I consider partnering with a set fee program?When you join the ARAG Attorney Network you will save on marketing costs associated with obtaining new clients because well direct plan members right to you. You will also save on administrative costs. ARAG pays you directly so there are no billing, collecting or write off costs associated with services provided to plan members. In addition, you can expect to develop a relationship with your satisfied plan members which will lead them back to you for matters outside of their legal plan coverage. Last, but not least, satisfied plan members generally refer their friends and family to their Network Attorney. These are additional out-of-network leads you may have an opportunity to develop at no additional marketing costs to you.</p> <p>Is there a fee to participate? How do I get paid?</p> <p>No. There is no fee to participate in the ARAG Attorney Network. Network Attorneys complete and submit claim forms for compensation according to a members legal plan. Some members have all attorney fees covered by ARAG and others pay a portion of attorney fees.</p> <p>Am I required to take ARAG clients?</p> <p>How will I know my application has been accepted?</p> <p>Our Provider Relations team will review your application and credentials. Upon acceptance to the Attorney Network, you will receive a welcome letter with additional details.</p> <p>No. ARAG does not require Network Attorneys to take every ARAG client that contacts them. We understand that many circumstances prohibit representation such as conflicts of interest, current case load, specific requirements of a case, and the timeliness of a case. We do ask that an ARAG case is never turned down because of attorney fees. This and more is covered in our ARAG Network Attorney Agreement available for review at:</p> <p>What happens after I join the ARAG Attorney Network?</p> <p>Can I continue to work with non-ARAG clients?</p> <p>Your name and contact information will be available to plan members through our Customer Care Center. Plus, members seeking legal assistance will have information about you and your firm right at their fingertips through our web site.</p> <p>Yes. Membership in the ARAG Attorney Network does not preclude an attorney from work with their current client base or from building it further.</p> <p>Do I need to practice in all the...</p>