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Subscriber Enrollment Form

IMPORTANT

This form must be completed with your payment and registration to activate your subscription and be eligible for benefits. Accounts without completed forms will be cancelled after 30 days.

Do not skip this form!

SUBSCRIBER INFORMATION

Name*
Address*

COVERED VEHICLE INFORMATION

New or Used?

LENDER & FINANCING INFORMATION

SUBSCRIPTION INFORMATION

MM slash DD slash YYYY


Alliance MSO, LLC
22001 Northpark Drive, Suite 200, Kingwood, TX 77339


Maximum Benefit Amount:
$7,500.00


Minimum Vehicle Price:
$5,000.00


Maximum Vehicle Price:
$125,000.00

TERMS AND CONDITIONS

TERMS AND CONDITIONS

This Subscription lasts for twelve (12) months from the day you apply for and pay the fee for this CPR for Cars™ SUBSCRIPTION PLAN (such day being the Subscription Date as set forth in the COVERED VEHICLE INFORMATION section of the Enrollment Form; and the twelve (12) month period beginning on such date being the Subscription Term). During the Subscription Term, You, the Subscriber, are entitled to the listed benefits, subject to the terms and conditions outlined herein.

WHAT YOU MUST DO TO KEEP THIS SUBSCRIPTION IN EFFECT

You, as the owner of the Vehicle and Subscriber under this Subscription, are required to maintain physical damage insurance on the Covered Vehicle for the full duration of the Subscription Term. Additionally, You must make every effort to maintain the Covered Vehicle in accordance with the manufacturer’s recommendations and take every reasonable precaution to avoid damage to the Covered Vehicle.

WHAT BENEFITS DOES THIS SUBSCRIPTION OFFER

During the Subscription Term, the following benefits are afforded to You to protect the value of the Covered Vehicle:

From the Subscription Date of this Subscription:

SECTION I – Covered Collision: If the Covered Vehicle is involved in a Covered Collision, which is not determined to be a Constructive Total Loss, and You are responsible for out-of-pocket expenses for the repair of the Covered Vehicle, We will provide You with up to a five hundred dollar ($500) discount towards these repairs, and/or for immediate expenses derived from a Covered Event.

SECTION II – Constructive Total Loss: If the Covered Vehicle is declared a Constructive Total Loss, We will provide You with a Vehicle Replacement Discount up to one thousand dollars ($1,000) towards the cost of Replacement Vehicle of equal or greater value.

SECTION III – Monthly Loan/Lease Payment: If the Covered Vehicle is required to be out of Your Care, Custody, or Control for more than seven (7) consecutive days, due to a Covered Service Event, We will reimburse You for a percentage of Your Monthly Loan/Lease Payment, up to 300% percent OR THREE (3) CONSECUTIVE MONTHS FOR THREE (3) REQUESTS FOR BENEFITS, NOT TO EXCEED $7,500.00 DURING THE Subscription Term.

Each benefit, including conditions, limitations, and exclusions, are more fully described on the following pages of this Subscription.

THE PURCHASE OF THIS SUBSCRIPTION IS NOT REQUIRED TO EITHER PURCHASE YOUR COVERED VEHICLE OR TO OBTAIN FINANCING. THIS IS NOT A VEHICLE LIABILITY INSURANCE CONTRACT. THIS IS NOT AN AUTOMOBILE PHYSICAL DAMAGE INSURANCE CONTRACT. IN ORDER FOR THIS SUBSCRIPTION TO BECOME EFFECTIVE IT MUST BE REGISTERED WITH THE CPR FOR CARS™ PROGRAM ADMINISTRATOR.

The headings contained in this Subscription are for convenience only and shall not be interpreted to limit or otherwise affect the provisions of this Subscription.

DEFINITIONS

Actual Cash Value: The retail value for a vehicle as determined by the NADA valuation guide or equivalent market valuation method.

Administrator, Obligor, We, Us or Our: ALLIANCE MSO, LLC at 1-866-549-4199.

Collision Repair: Repairs that are required as the result of an accident or upset involving the Covered Vehicle, regardless of fault.

Commercial Use: Includes use of the Covered Vehicle for a business in any manner including, without limitation, taxi, police car or other emergency vehicle, hauling, construction (other than driving to and from work), pick-up and delivery service, daily rentals, carry passengers for hire, snowplowing and company carpool use or business travel when the Covered Vehicle is used by more than one driver.

Constructive Total Loss: A loss in which the Covered Vehicle has been declared a total loss or unrecovered theft by the Primary Insurance Carrier.

Covered Collision: An event whereby the Covered Vehicle, while under Your control, comes into direct contact with another vehicle or object and damage results, excepting for a Constructive Total Loss, and the liable party’s collision insurance provides coverage for such damage.

Covered Service Event: The Covered Vehicle is out of Your Care, Custody or Control for the purposes of: Collision Repair (including recall repairs), Vandalism, or Mechanical Breakdown, as specified in the repair order or other supporting documentation. (A Constructive Total Loss is not considered a Covered Service Event).

Covered Vehicle: The automobile (including an electric powered vehicle) described in the COVERED VEHICLE INFORMATION section of the Enrollment Form. The Covered Vehicle shall be the vehicle identified by the Vehicle Identification Number (VIN) provided in the Enrollment Form.

CPR for Cars™ Benefit Amount: The monetary amount for which You will be reimbursed, based on the number of days in which the Covered Vehicle is out of Your Care, Custody, or Control, as listed in the schedule located in WHAT DOES THIS SUBSCRIPTION COVER – SECTION III.

Enrollment Form: All information supplied in the Enrollment Form above constitutes the form. The information supplied by You must be accurate and kept up to date. Any misrepresented information, fraud, etc. is grounds for cancellation of Subscription.

Finance Contract: The financing agreement, loan agreement, retail installment contract, or lease agreement for the purchase or lease of the Covered Vehicle for which You are financially responsible to make equal monthly payments on a specific date each calendar month.

Lender: Financial institution identified under the LENDER & FINANCING INFORMATION section of the Enrollment Form.

Mechanical Breakdown: A Covered Vehicle experiences failure of an original manufactured part or parts under normal wear and it can no longer perform its function as designed.

Monthly Loan/Lease Payment: The fixed payment listed in Your Finance Contract, made by You to the Lender.

Primary Insurance Carrier: The insurance company that: (1) is secured by You to provide vehicle collision insurance coverage on the Covered Vehicle; or (2) provides liability coverage to any person who has caused collision damage to Your Covered Vehicle for which that person is legally liable; or (3) any other company providing You coverage protecting Your interest in the Covered Vehicle, contingent upon failure or absence of Your primary insurance carrier coverage.

Replacement Vehicle: The automobile purchased or leased to replace the Covered Vehicle.

Seller: The distributor of this Subscription identified in these Terms and Conditions under the SUBSCRIPTION PROVIDER INFORMATION section of the Enrollment Form.

Subscriber, You, or Your: The vehicle owner, by means of a valid state-issued vehicle registration and matching valid state-issued driver’s license of the Covered Vehicle and recipient of this Subscription as identified under the SUBSCRIBER INFORMATION section of the Enrollment Form.

Subscription: This document which outlines the terms, conditions, exclusions, and limitations as they pertain to the Subscription Plan.

Subscription Date: The date that Your Subscription begins.

Term or Subscription Term: Regarding SECTION I and SECTION II one (1) year from the Subscription Date in these Terms and Conditions. Regarding SECTION III until the Finance Contract has been satisfied, not to exceed twelve (12) months from the Subscription Date in these Terms and Conditions.

Vandalism: An act of malicious mischief that results in damage to the Covered Vehicle for which a police report has been filed and the vehicle is undrivable.

Vehicle Replacement Discount: The amount discounted to You by Us, towards the purchase or lease of a Replacement Vehicle.

Your Care, Custody, or Control: The Covered Vehicle was voluntarily released by You to another party and the party has assumed temporary possession of the Covered Vehicle, for the sole purpose of a Covered Service Event as defined in this Subscription.

LIMITATION OF LIABILITY

The Obligor’s maximum liability for this Subscription, is limited to seven thousand five hundred dollars ($7,500). Each Covered Event may specify additional limitations and these limitations will be considered the maximum liability for Us regarding that benefit. Unless required by state law, We shall not be held liable for incidental, consequential or punitive damages. We shall have no other liability or obligation of any nature whatsoever arising from this Subscription unless otherwise required by state law.

HOW LONG DOES THIS SUBSCRIPTION LAST? AUTOMATIC RENEWAL

This Subscription begins on the Subscription Date listed in these Terms and Conditions under the COVERED VEHICLE INFORMATION section and continues, without lapse, for the full length of the Subscription Term. Your Subscription shall automatically renew at the current Subscription Fee on the date of renewal using your credit or debit card on file (or such other card as you provide to us) unless you send us a notice in writing or by email requesting not to renew Your Subscription (any renewed Subscription Term being a Renewed Subscription Term).

HOW TO REQUEST BENEFITS UNDER THIS SUBSCRIPTION

In the event You need to request a benefit under this Subscription, refer to the applicable benefit section, under the WHAT DOES THIS SUBSCRIPTION COVER section, for specific instructions on how to proceed. For additional instruction You may contact the Administrator.

WHAT ARE OUR OBLIGATIONS UNDER THIS SUBSCRIPTION?

In the event that You request benefits under this Subscription, and follow all the instructions for the applicable benefit, under the WHAT DOES THIS SUBSCRIPTION COVER section, We will, make every effort to satisfy any amounts owed to You under this Subscription within a reasonable time frame, not to exceed thirty (30) days, from the completion of the benefit request process.

The Administrator reserves the right to inspect for liability or may request estimates for repair and/or photographs of the damage to determine the validity of the request. The Administrator shall notify You within ten (10) business days of processing the request, whether the request will be allowed or denied and if denied, the specific reasons for the denial.

This Subscription must be registered with the Administrator to be considered valid. Failure by the Seller to register this Subscription with the Administrator may release the Administrator from some or all of its obligations. In the event that this Subscription is not registered with the Administrator, at the time of Your request for a benefit, We will make every reasonable effort to remedy the situation without impacting the validity of Your request. In the event that We are unable to remedy the situation, We may, at our sole discretion, offer to You a one-time settlement, not to exceed the actual value of the benefit.

WHAT ARE NOT OUR OBLIGATIONS UNDER THIS SUBSCRIPTION

The Administrator, shall not have any obligation to:

  1. File any claim with any party, includingYour or a third party’s Primary Insurance Carrier.
  2. Offer toYou any opinion, amateur or professional, on the validity of any value, estimated or actual, regarding duration, cost, or goods, associated with any benefit request made under this Subscription, other than the values provided by a professional company qualified to determine such values.
  3. AssistYou in obtaining, any or all, documentation required to file or proceed with an insurance claim or benefit request.
  4. Make or offer any warranty of merchantability or warranty of fitness for any particular purpose under this Subscription.

Any requirement defined in this Subscription that is expressly disclaimed above shall be considered solely Your responsibility. Your failure to perform any responsibility under this Subscription may impact your ability to collect any amounts offered under this Subscription.

WHAT DOES THIS SUBSCRIPTION COVER?

The sum of all benefits paid under this Subscription shall not exceed seven thousand five hundred dollars ($7,500).

This Subscription provides protection for You, the Subscriber, for your Covered Vehicle. In the event a change in Covered Vehicle is submitted, any benefits paid to You on the original Covered Vehicle will remain and count towards your Subscription limits. Cancellation and reinstatement of Your Subscription do not negate prior benefits. A change in your Subscriber information (phone number, email address, physical address, etc.) or issue of a valid Driver’s License in a state different from that originally supplied do not negate prior benefits.

THE FOLLOWING BENEFITS ARE OFFERED IN CONJUNCTION WITH THIS SUBSCRIPTION

SECTION I – Covered Collision: If the Covered Vehicle is involved in a Covered Collision for which You incurred expenses beyond those covered by the liable party’s Primary Insurance Carrier, We, where allowed by State law, will discount an amount equivalent to Your expenses to repair the Covered Vehicle, up to five hundred dollars ($500), for the repairs performed and/or for immediate expenses derived from the Covered Event. This benefit shall apply only to insurance claims:

  • resulting from a Covered Collision in which the cost to repair and verified expenses of the Covered Vehicle exceeds five hundred dollars ($500), and
  • provided the liable party’s collision insurance company pays the balance of the claim.

How to Request a Benefit: You must notify the Administrator within five (5) days after the Covered Collision has been reported to Your Primary Insurance Carrier, by filing a request for benefits through your cprforcars.com login and submitting the documents listed below to the Administrator within thirty (30) days of the primary insurance settlement for the Covered Collision. In the event You file a request for benefits under this Subscription, any remaining balance due for Your Annual Subscription Fee (if You are making monthly or quarterly payments) shall be deducted from any benefit amount paid to You.

  1. A valid Subscription ID Number at the time of the event.
  2. A copy of the complete collision repair order.
  3. A copy of Your collision insurance policy, including the Declarations Page, as issued by Your Primary Insurance Carrier.
  4. A copy of the Insurance Settlement check from the liable party’s Primary Insurance Carrier.
  5. Written documentation from the liable party’s Primary Insurance Carrier substantiating the type of loss, the date of loss, and the date the claim was filed.
  6. A copy of Your Driver’s License, valid at the time of the event.

SECTION II – Constructive Total Loss: If the Covered Vehicle is declared a Constructive Total Loss, during the Subscription Term or any Renewed Subscription Term, We will provide you with a Vehicle Replacement Discount, up to one thousand dollars ($1,000) towards the purchase or lease of a Replacement Vehicle, which has an Actual Cash Value that is greater than or equal to that of the Covered Vehicle. and can be applied at the dealership of Your choice.

This Subscription is limited to the issuance of one (1) benefit under this Constructive Total Loss section during the Subscription Term or any Renewed Subscription Term.

How to Request a Benefit: You must report the Constructive Total Loss to law enforcement within twenty-four (24) hours. Additionally, You must provide the Administrator with the following items within thirty (30) days of payment from the Primary Insurance Carrier:

  1. A valid Subscription ID Number at the time of the event.
  2. A copy of the Covered Vehicle’s and the Replacement Vehicle’s bill of sale.
  3. A copy of the police report.
  4. A copy of the Replacement Vehicle’s loan/lease contract, if applicable.
  5. Verification from the primary insurance carrier substantiating the date and cause of the Constructive Total Loss and net loss amount, with proof of its payment.
  6. A copy of Your Driver’s License, valid at the time of the event.

SECTION III – Monthly Loan/Lease Payment: If the Covered Vehicle is required to be out of Your Care, Custody, or Control for seven (7) or more consecutive days, due to a Covered Service Event, We will reimburse You for a percentage of Your Monthly Loan/Lease Payment based on the following schedule:

Days out of Your Care, Custody, or Control / CPR for Cars™ Benefit Amount**

Seven (7) to Fifteen(15) Days / 50% of Your Monthly Loan/Lease Payment

Sixteen (16) to Thirty (30) Days / 100% of Your Monthly Loan/Lease Payment

Thirty-One (31) to Sixty (60) Days / 200% of Your Monthly Loan/Lease Payment

Sixty-One (61) or more Days / 300% of Your Monthly Loan/Lease Payment

**At no point shall the CPR for Cars™ Benefit Amount exceed the total cost of the repair order.

This Subscription is limited to the issuance of three (3) consecutive Monthly Loan/Lease Payments for three (3) Covered Events under this Monthly Loan/Lease Payment section during the Subscription Term or any Renewed Subscription Term.

How to Request a Benefit: In the event that You need to request a benefit under this Subscription, You must provide the following documents to the Administrator within thirty (30) days of the completion of the repair:

  1. A valid Subscription ID Number at the time of the event.
  2. A copy of Your Finance Contract showing the Covered Vehicle and the terms of the contract including the inception date, Lender, and the Monthly Loan/Lease Payment
  3. A copy of the repair order for the Covered Service Event, showing the date the repair was started and the date the repair was completed, as well as an itemized list of the services performed.
  4. A copy of Your Driver’s License, valid at the time of the event.
  5. Any additional reasonable documentation requested by the Administrator.

HOW TO CANCEL OR TRANSFER THIS SUBSCRIPTION

Cancellation:

By You: Provided that no benefit has been issued under this Subscription, You may cancel this Subscription by submitting a written or emailed request to the Administrator that includes a Valid Subscription ID Number. During the first five (5) days from the Subscription Date, We will refund You 100% of the Subscription purchase price. After five (5) days, the refund price shall be pro rata.

Once received, We will cancel Your Subscription as of the postmark date, or date of receipt in the case of email notification. Any amount paid on your Subscription up through the date of cancellation shall be non-refundable. You will be notified of the cancellation of Subscription either in writing or to the email address on your Enrollment Form.

In the event any benefit(s) have been issued under this Subscription, any remaining amount due for Your annual Subscription fee shall be charged to the payment method You provided.

If you feel Your Subscription was initiated through an act of fraud, identity theft, or without Your permission. Contact the Administrator within five (5) business days to report suspicious activity, request a refund, and terminate Your Subscription.

By Us: We may only cancel this Subscription if the Covered Vehicle does not qualify for benefits, or for material misrepresentation, or fraud by You. If We cancel this Subscription, We will refund You 100% of the Subscription purchase price and mail to You a notice outlining the specific nature of reason for cancellation. The validity of the Subscription will cease no more than five (5) days from the postmark date of such notice.

Transfer: This Subscription is not transferable to any other person. In the event of a change of ownership or completion of loan or lease payments for the Covered Vehicle, the Subscriber shall notify the Administrator by phone, email, or in writing within five (5) business days. In the event the Subscriber needs to change the Covered Vehicle of their Subscription, either through Constructive Total Loss or any other reason, the Subscriber must contact the Administrator by phone, email, or in writing within ten (10) business days and supply any requested documentation within thirty (30) days, failure to do so may terminate this Subscription.

HOW TO DISPUTE A BENEFIT REQUEST

Both the Obligor and You agree that, prior to taking any formal legal action, all disputes and controversies of every kind and nature arising out of this Subscription shall be submitted to arbitration administered by the American Arbitration Association (AAA), in accordance with its rules for such cases then in effect, and any judgment on the award rendered by the arbitrator may be entered in any court having jurisdiction thereof. The prevailing party shall be entitled to an award of reasonable attorneys’ fees as well as costs and fees of arbitration. Either party may request that the award of the arbitrator be accompanied by a reasoned opinion.

WHAT THIS SUBSCRIPTION DOES NOT COVER

The benefits afforded under this Subscription does not apply to:

General Exclusions:

  1. Any Subscription not registered with the Administrator. You must register for an account online at cprforcars.com and complete the Enrollment Form.
  2. Any incidental or consequential loss or damage whatsoever, including but not limited to: loss of use; damage or injury to person or property; rental car, travel or accommodation expenses; or any other expense that does not directly relate to the benefit provided by this Subscription.
  3. Any loss for which there was no physical damage insurance in place on the Covered Vehicle at the time of the loss.
  4. The Covered Vehicle being used for Commercial Use, snow plowing, competition, or speed events.
  5. Any benefits requested arising from conditions that existed prior to inception of or after the expiration of the Subscription Term.
  6. The Covered Vehicle being modified from the manufacturer’s original specifications regardless of when the modifications were made.
  7. Any Subscription obtained or benefit requested, through misrepresentation of material facts or fraud.
  8. Any loss that occurs outside of the United States, its territories, or possessions.
  9. Any loss that occurs prior to or after the expiration of the Subscription Term.
  10. Any loss, damage, or delay in repairs resulting from, but not limited to, manufacturer’s defect, war, whether or not declared, invasion, civil war, insurrection, rebellion or revolution, nuclear reaction, radioactive contamination, national disasters, state emergencies, any and all power surge or outage events, acts of God.
  11. Any loss resulting directly or indirectly from any dishonest, fraudulent, illegal, or criminal act by You or anyone acting on Your behalf, whether acting alone or in collusion with others; or due to conversion, secretion, or embezzlement by any person in lawful possession of the Covered Vehicle.
  12. Any amount in excess of the maximum liability or stated limitations in each benefit section of this Subscription.
  13. Any Covered Vehicle for which the purchase price is less than five thousand dollars ($5,000) or greater than one hundred twenty-five thousand dollars ($125,000).
  14. Any Covered Vehicle with a salvage, rebuilt or branded title.
  15. Any of the following vehicles or vehicle types: any vehicle having a gross vehicle weight rating in excess of fifteen thousand (15,000) pounds; exotic or one off vehicle, including, but not limited to: Alfa Romeo, Alpina, Ascari, Avanti, Bugatti Noble, Pagani, Panoz, Saleen, Spyker, TVR, Daewoo, Bentley, Lamborghini, Lotus, Maserati, Ferrari, Rolls Royce,; recreation vehicle; cargo van; limousine; taxi; bus; vehicle used for rental or in a fleet; box, dump, flat bed, semi cab, towing or utility trucks; a vehicle which has been classified as a “lemon” and has not been corrected.

In addition to everything listed above in the section entitled General Exclusions, the following are not protected by this Subscription with respect to:

SECTION I – Covered Collision:

  1. Any loss for non-collision repair work or where the loss does not qualify as a Covered Collision.
  2. Any loss where the collision insurance claim is filed: (a) under a name other than the Subscriber’s name; (b) for a vehicle other than the Covered Vehicle.
  3. Any loss where the total cost to repair the Covered Vehicle is less than five hundred dollars ($500) or the Subscriber had no out-of-pocket expenses.
  4. Any expense that is not directly related to the physical repair of the Covered Vehicle.
  5. Any loss where the Administrator has not received the required documentation within thirty (30) days of the primary insurance settlement dispersal; or
  6. Any loss in which the repairs were not performed at a facility licensed to perform such repairs or make such determinations as to cost, duration, or value in conjunction with a benefit request.

In addition to everything listed above in the section entitled General Exclusions, the following are not protected by this Subscription with respect to:

SECTION II – Constructive Total Loss:

  1. Any loss that is not deemed a Constructive Total Loss.
  2. Any loss where the Administrator has not received the required documentation within sixty (60) days of the primary insurance settlement dispersal; or
  3. Any Replacement Vehicle which has an Actual Cash Value less than that of the Covered Vehicle.

In addition to everything listed above in the section entitled General Exclusions, the following are not protected by this Subscription with respect to:

SECTION III – Monthly Loan/Lease Payment:

  1. Any service event that does not qualify as a Covered Service Event under this Subscription.
  2. Any Covered Service Event not performed by a facility licensed to perform such repairs or make such determinations as to cost, duration, or value in conjunction with a benefit request.
  3. Any repair which the manufacturer’s guidelines suggest such repair duration will be in excess of seven (7) days.
  4. Any event resulting in temporary loss of use due to lack of fuel (gasoline or electric charge).
  5. Any Covered Service Event where the required documentation was not supplied to the Administrator within thirty (30) days of completion of the repair.
  6. Any Covered Service Event which does not require the Covered Vehicle to remain out of Your Care, Custody, or Control for the duration of the Covered Service Event, even if You choose to allow the Covered Vehicle to remain out of Your Care, Custody, or Control for the duration of such event.
  7. Any delay in repairs to the Covered Vehicle caused by:
  • You receive possession of the Covered Vehicle after the repair is completed including but not limited to any completed repairs that are not to Your satisfaction.
  • Confiscation or repossession of the Covered Vehicle.
  • Parts being unavailable outside of the body/mechanical repair facility’s control including but not limited to loss of shipment or parts that are no longer manufactured.
  • Any intentional acts by You, including a misstatement or misrepresentation of facts; or
  • Any service event after which three (3) CPR for Cars™ Benefit Amounts and/or three (3) requests/occurrences have been paid during the Subscription Term or any Renewed Subscription Term under this Subscription.

SEVERABILITY

If any provision, or portion thereof, of this Subscription is, or becomes, invalid under any applicable statute or rule of law, it is to be deemed stricken and the rest of this Subscription shall remain in full force and effect.

FOR INFORMATION ABOUT YOUR CPR FOR CARS™ SUBSCRIPTION OR TO FILE A REQUEST FOR BENEFITS PLEASE CONTACT THE PROGRAM ADMINISTRATOR – ALLIANCE MSO, LLC BY CALLING: 1-866-549-4199

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