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IC 24-12-4
Chapter 4. Disclosures
IC 24-12-4-1
Required CPAP contract disclosures
Sec. 1. Each CPAP contract must contain the disclosures specified
in this section, which are material terms of the contract. Unless
otherwise specified, the disclosures must be in at least a 12 point
bold font and be placed clearly and conspicuously within the
contract. The following disclosures are required:
(1) On the front page, under appropriate headings, language
specifying:
(A) the funded amount to be paid to the consumer claimant
by the CPAP provider;
(B) an itemization of one (1) time charges;
(C) the total amount to be assigned by the consumer
claimant to the CPAP provider, including the funded amount
and all charges; and
(D) a payment schedule including the funded amount and all
charges, listing all dates and the amount due at the end of
each one hundred eighty (180) day period, from the funding
date until the date on which the maximum amount due to the
CPAP provider by the consumer claimant occurs.
(2) A notice within the body of the contract stating the
following: "Consumer Claimant's Right to Cancellation: You
may cancel this contract without penalty or further obligation
within five (5) business days after the funding date if you either:
(A) return to the CPAP provider the full amount of the
disbursed funds by delivering the provider's uncashed check
to the provider's office in person; or
(B) mail, by insured, certified, or registered United States
mail, to the CPAP provider at the address specified in the
contract, a notice of cancellation and include in the mailing
a return of the full amount of disbursed funds in the form of
the provider's uncashed check or a registered or certified
check or money order.".
(3) A notice informing the consumer claimant that the CPAP
provider has no role in deciding whether, when, and how much
the civil proceeding is settled for. However, the consumer
claimant and consumer claimant's attorney must notify the
CPAP provider of the outcome of the civil proceeding by
settlement or adjudication before the resolution date. The CPAP
provider may seek updated information about the status of the
civil proceeding but in no event may the provider interfere with
the independent professional judgment of the attorney in the
handling of the civil proceeding or any settlement.
(4) Within the body of the contract, in all capital letters in at
least a 12 point bold font contained within a box the following:
Indiana Code 2016
"THE FUNDED AMOUNT AND AGREED UPON CHARGES
SHALL BE PAID ONLY FROM THE PROCEEDS OF YOUR
CIVIL PROCEEDING, AND SHALL BE PAID ONLY TO
THE EXTENT THAT THERE ARE AVAILABLE
PROCEEDS FROM YOUR CIVIL PROCEEDING. YOU
WILL NOT OWE (INSERT NAME OF THE CIVIL
PROCEEDING ADVANCE PAYMENT PROVIDER)
ANYTHING IF THERE ARE NO PROCEEDS FROM YOUR
CIVIL PROCEEDING, UNLESS YOU HAVE VIOLATED
ANY MATERIAL TERM OF THIS CONTRACT OR YOU
HAVE COMMITTED FRAUD AGAINST THE CIVIL
PROCEEDING ADVANCE PAYMENT PROVIDER.".
(5) Located immediately above the place on the contract where
the consumer claimant's signature is required, in at least a 12
point bold font the following: "Do not sign this contract before
you read it completely or if the contract contains any blank
spaces. You are entitled to a completely filled in copy of the
contract. Before you sign this contract, you should obtain the
advice of an attorney. Depending on the circumstances, you
may want to consult a tax, public or private benefits planning,
or financial professional. You acknowledge that your attorney
in the civil proceeding has provided no tax, public or private
benefit planning, or financial advice regarding this
transaction.".
As added by P.L.153-2016, SEC.7.
Indiana Code 2016
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