It is sometimes necessary for LegalWise to refer a LegalWise Member to an attorney. This usually occurs when the member has a legal problem that must be heard in court. These are often cases where a member has been charged with committing an offence (a criminal matter) and/or civil disputes (litigation). LegalWise may not, by law, handle these legal problems in- house.
When a LegalWise Member is referred to an attorney it is important that he or she follows the procedure recommended by us in order to claim insurance for his or her legal fees.
LODGING A CLAIM
The fact that you have been advised by LegalWise to consult an attorney does not mean that your legal fees will be insured.
It simply means that the Legal Counsellor at one of our branches was of the opinion that your problem needed the attention of an attorney.
In the first consultation with the attorney, inform him or her that you are a member of LegalWise and enquire whether he or she will represent you in terms of the LegalWise Policy Conditions and Tariffs (131Kb PDF).
Ensure that you and your attorney complete and sign a Claim Notification (66.2Kb PDF) Form
The Claim Notification (66.2Kb PDF) Form, with all required information and documents, should be sent to your local LegalWise Branch. The claims staff at your local branch should be telephoned for all claims related queries.
Remember at this stage your legal fees are not insured.
Only once LegalWise sends a written Confirmation of Cover to your attorney will your legal feed be insured in line with any conditions of cover as well as in accordance with our policy.
Due to the complexity of legal problems, LegalWise does not confirm insurance over the telephone.
PAYMENT PROCEDURE
Once a written Confirmation of Cover has been sent to your attorney and all the documents requested by LegalWise have been received by the LegalWise Claims Department, your attorney should send an itemised bill to your local LegalWise Branch.
The itemised bill must be drawn up in accordance with the LegalWise Tariffs (131Kb PDF).
If your attorney would like to claim VAT on his or her services, the bill should include the practice’s VAT registration number and should state TAX INVOICE.
When the claims staff at your local branch receives your attorney’s bill as well as all the requested documents, they will check that the bill has been drafted in accordance with LegalWise Tariffs (131Kb PDF).
Please note that any amounts that are not in accordance with LegalWise Tariffs (131Kb PDF) will not be paid.
Your attorney’s account is then processed and paid.
ATTORNEYS WHO WORK WITH LEGALWISE
Usually the attorney to whom we refer the member works in line with the LegalWise Policy Conditions and Tariffs (131Kb PDF).
If this is the case then the member does not have to pay anything, other than the First Amount Payable or “excess fee”, because LegalWise will settle the attorney’s bill in full.
However, some attorneys do not work according to LegalWise Policy Conditions and Tariffs (131Kb PDF), or our members prefer to use their own attorneys. In cases like these, the member will be required to pay the difference between what LegalWise will pay and what the attorney has charged.
For as long as you are a paid up LegalWise Member, the first amount payable or “excess fee” (three times the monthly premium) will fall away if the first consultation takes place 24 months after commencement of cover. The same will apply if subsequent consultations occur 24 months apart.
During the first consultation, it is important that the LegalWise Member finds out whether or not the attorney will represent him according to LegalWise Tariffs (131Kb PDF).
ATTORNEY BRANCHES
Our aim is to establish and grow our network of service providers so that our members have service points, which are accessible. This network is made up of our large LegalWise Branches, Tupacs and Attorney Branches. This means that the Attorney Branches are not isolated entities somewhere out there but that they form an integral part of our service network.
What does an Attorney Branch do and how does an Attorney Branch differ from other firms of attorneys?
We look at areas in the country where we feel there are service gaps – areas in which there is a high density of members but where it is difficult and expensive for them to get to our branches. In those areas we have approached firms of attorneys that have a good reputation and LegalWise enters into agreements with them to become Attorney Branches.
At LegalWise we strive to build an excellent relationship with our Attorney Branches by fostering communication between Attorney Branches and their closest LegalWise Branch. Our aim is to include the Attorney Branches in what we are doing as a company. We expect excellent service from them and we should also strive to deliver
