Electronic Acknowledgment Regarding Appointment of Clements Worldwide as Attorney in Fact, and Terms and Conditions of Obtaining International Health Insurance Coverage from Lloyd’s of London

By requesting a Quote, submitting an Application for Coverage, or by purchasing any of the health insurance policies offered by Clements Worldwide from certain underwriters at Lloyd’s of London (“Lloyd’s”), you, the Applicant or Insured, agree to the following terms and conditions.

1. The term “Applicant” means the person requesting a quote and/or applying for health insurance coverage under any policy described in this website that is issued by Lloyd’s.  The term Applicant also applies to all parties to be included as insureds and beneficiaries under such policies.

2. The term “Clements Worldwide” means Clements & Company, Inc., an insurance agency licensed as an insurance agency, surplus lines broker and producer in the District of Columbia and throughout the United States.  Clements Worldwide’s principal place of business in the United States is One Thomas Circle N.W., 8^th Floor, Washington, D.C. 20005.  Clements Worldwide also maintains offices in London and Dubai. 

3. The term “Insured” means all persons listed as insureds and beneficiaries under any policies bound or issued by Lloyd’s.

4. Any policy purchased from Lloyd’s is being purchased for the purpose of insuring you outside of the United States during the course of an overseas assignment (“International Insurance Policy”).

5. Any International Insurance Policy issued in connection with this transaction is intended to provide worldwide global coverage while the Insured is abroad and, other than potentially incidental coverage while on return travel to the Insured’s home country, the policies are not intended to provide insurance coverage to the Insureds while residing in the United States.

6. The International Insurance Policies sold under this program are being sold on a non-admitted or surplus line basis.  This means that the terms and conditions of the policies may not comply with state insurance laws or regulations and that the inability of Lloyd’s to pay claims is not covered by the insurance guaranty funds of the District of Columbia or other jurisdictions in the United States (the “State Guaranty Funds”).  However, the members of Lloyd’s have established their own guaranty fund, the Central Guaranty Fund, in the event that a subscribing underwriter should become unable to pay claims for financial reasons.

7. Because of the transient nature of the Applicant’s and/or Insured’s circumstances and overseas assignment, the Applicant and/or Insured and Clements Worldwide agree that this transaction and all matters relating to this transaction shall be deemed to occur exclusively within the District of Columbia in the United States of America.

8. The Applicant and/or Insured hereby appoints Clements Worldwide as his/her attorney in fact, and Clements Worldwide accepts this appointment, to:

a. Make application for all International Insurance Policies offered by Clements Worldwide in the District of Columbia;

b. Accept delivery on behalf of all Insureds under International Insurance Policies sold by Clements Worldwide in the District of Columbia;

c. Remit payments made by or on behalf of the Insureds to the Insurer in the District of Columbia for premiums due;

d. Accept and transmit all correspondence with the Insurer in the District of Columbia;

e. Forward to the Applicant and/or Insured all policies, correspondence and premium notices to any postal address or internet email address requested by the Applicant and/or Insured; and

f. Remit any premium taxes relating to premiums paid for International Insurance Policies to the District of Columbia Collector of Taxes. 

9. The parties agree that the attorney in fact appointment shall not be revoked until all matters regarding the International Insurance Policies and any claims thereunder are satisfied and completed.

10. By proceeding with this transaction over the internet, the parties agree to conduct this transaction by electronic means.  If any law requires a person to provide, send, or deliver information in writing to another person, such a requirement shall be satisfied if the information is provided, sent, or delivered, as the case may be, in an electronic record capable of retention by the recipient at the time of receipt.

11. Counterparts.  This Agreement may be executed in any number of counterparts, each of which shall be an original, but all of which, when taken together, will constitute one and the same instrument.  A signature delivered by facsimile or PDF will be sufficient for all purposes among the parties.

12. The parties agree that all questions with respect to this transaction or the rights and liabilities of the parties hereunder shall be determined in accordance with the laws of the District of Columbia.  Any regulatory complaint made or to be made by either party shall be made only to the Department of Insurance, Securities and Banking for the District of Columbia.  Any legal or equitable action taken or to be taken by either party regarding this transaction or the rights and liabilities of parties hereunder shall be brought only before the Superior Court of the District of Columbia.  Each party hereby consents to the jurisdiction and venue of this Court.

13. Waiver of Jury Trial.  ALL PARTIES TO THIS TRANSACTION HEREBY WAIVE TRIAL BY JURY IN ANY ACTION, PROCEEDING, SUIT, COUNTERCLAIM, CROSS-CLAIM OR THIRD-PARTY CLAIM BROUGHT BY ANY OF THE PARTIES HERETO ON ANY MATTERS WHATSOEVER ARISING OUT OF OR IN ANY WAY RELATED TO OR CONNECTED WITH THIS TRANSACTION.

INFORMATION WE SHARE WITHIN OUR CORPORATE FAMILY

Clements Worldwide is based in the United States, and our subsidiary Clements Europe Limited is in the United Kingdom.  We may share information about you with both entities for the purpose of providing, managing and administering the services and products offered to you.