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Umpire Rate Agreement
Policyholder:
Insurer:
Claim No.:
Type of Loss:
Date of Loss:
Willie Harris, of Alternative Dispute Resolution MA, has been jointly appointed by the respective Appraisers to act as the neutral Umpire to resolve any disputes, differences, or disagreements for the amount of loss that have arisen between the two (2) Appraisers relative to the above referenced Claim/Appraisal.
Payment for the Umpire’s services is the responsibility of both the Policyholder and the Insurer and is divided FIFTY PERCENT (50%) between those parties as stated in the appraisal clause of the insurance policy. It is understood by the undersigned that the fees for the Umpire’s services are Negotiable, not including travel time portal to portal, plus expenses. When appropriate, travel expenses may include mileage at the prevailing government rate, airfare, lodging, and a $99.99 meal per diem. If it is necessary to have an unusual expense (for example: expert consultant, specialized testing, vertical access equipment, etc.) the Umpire will consult both Appraisers before incurring any such unusual expense.
The Policyholder acknowledges and understands that the Umpire’s invoice is TOTALLY SEPARATE from any payments issued by the Insurer to the Policyholder on this Claim/Appraisal, or any amounts being charged to the Policyholder by their Attorney, Public Adjuster, Appraiser, or Contractor.
The Umpire’s invoice is due Net 10 days. In the event that the Umpire should incur legal fees or costs to enforce this Umpire Rate Agreement and/or to collect the Umpire’s fees and expenses in conjunction with the Claim/Appraisal, the Umpire shall recover his attorney’s fees and costs, including appellate fees and costs, plus a service charge of 1.5% per month (18% per annum) from any non-
By Policyholder/Authorized Representative By Insurer/Authorized Representative
________________________________________ ______________________________________________
Print Name & Title Print Name & Title
_____________________________________________ ________________________________________________
Date Date
__________________________________ __________________________________
Return executed agreement to:
The Justice Center
Alternative Dispute Resolution MA
4900 Fournace Place, Suite 200A
Bellaire, TX 77401
wharris@adrma.com