FMH Policyholders

FMH is dedicated to providing language assistance services, free of charge, to Limited English Proficiency (LEP) persons who do not speak English as their primary language and/or who have a limited ability to read, speak, write, or understand English.  Language services can be provided by oral interpretation or written translation.  For assistance, you may submit the Language Assistance Request Form or contact the FMH Help Desk at 800-532-1581 or via email at HelpDesk@fmh.com

CLICK HERE FOR LANGUAGE ASSISTANCE FORM

FMH Póliza

FMH se dedica a servicios de idioma ayuda, gratuitamente, a personas de dominio de inglés limitado (LEP) que no hablan inglés como primer idioma o que tienen una capacidad limitada para leer, hablar, escribir o entender el inglés. Servicios lingüísticos pueden ser proporcionadas por la interpretación oral o escritos traducción. Para asistencia, puede presentar el formulario de solicitud de asistencia de idioma o póngase en contacto con la FMH Help Desk en 800-532-1581 o por correo electrónico a  HelpDesk@fmh.com

HAGA CLIC AQUI PARA FORMULARIO DE SOLICITUD DE ASISTENCIA DE IDIOMA

The guidelines below apply when a policyholder is digitally signing insurance documents from a remote location.

FMH encourages its appointed agents and policyholders to transact business electronically and improve service and efficiency by digitally signing forms necessary to secure an insurance policy offered by FMH. Prior to accepting digital signatures, agents are responsible for obtaining policyholder consent and for providing any necessary consumer disclosures. Agents are also responsible for obtaining the policyholder’s email address and for ensuring the email address on file is current. A proper digital signature process will authenticate the signer’s identity, ensure the document was timely signed and not altered after signature, and create an audit trail or certification of the signing process.

The digital signature process generally begins with the agent uploading the form to a secure third-party site and designating on the form where the digital signature should be applied. Once the form is uploaded for signature, the policyholder receives a link or electronic notice with instructions on how to access the form and complete the signature process. On initial use, the digital signature software should prompt the signer to create a user profile or otherwise authenticate their identity with a password, policy number, or other unique identifier. The policyholder would then digitally sign and submit the document. The digital signature settings should preferably be configured to apply a date stamp on the form, in or near the signature block, similar to the following: “DIGITALLY SIGNED BY J. Doe on 2014-03-29 15:02:15 CST.” Once all required signatures are obtained, the document should be uploaded to the FMH Agent Center and/or stored in the agency files. If a change is needed to a document that has already been digitally signed, the revised document must be resubmitted for a new digital signature.

Typical free software (e.g., Adobe Acrobat Reader) should not be used as these programs generally do not incorporate digital technology processes and security. If FMH believes an electronic signature was not obtained using a digital signature process, FMH may reject the form or request additional supporting documentation from the agent or directly from the policyholder or person signing with the policyholder’s authority. Upon any such request by FMH or any regulatory body, the agent must provide an audit trail or other satisfactory documentation showing the form was timely signed by a person with the legal authority to sign.

Agents must abide by the document retention periods as set forth by FMH or any regulatory authority and be able to provide copies of all digitally signed documents within the time set forth in the Agency Agreement or any applicable addendum thereto.

Discrimination Complaint Filing by USDA Customers

USDA prohibits discrimination against its customers. If you believe you experienced discrimination when obtaining services from USDA, participating in a USDA program, or a program that receives financial assistance from USDA, you may file a complaint with USDA. OASCR, through the Office of Adjudication, will investigate and resolve complaints of discrimination in programs operated or assisted by USDA.

USDA prohibits discrimination on the bases of race, color, religion, sex, age, national origin, marital status, sexual orientation, familial status, disability, limited English proficiency, or because all or a part of an individual's income is derived from a public assistance program. In programs that receive Federal financial assistance from USDA, discrimination is prohibited on the bases of race, color, religious creed, sex, political beliefs, age, disability, national origin, or limited English proficiency. (Not all bases apply to all programs.) Reprisal is prohibited based on prior civil rights activity.

To file a program discrimination complaint, please complete the USDA Program Discrimination Complaint Form. You or your authorized representative must sign the complaint form. You are not required to use the complaint form. You may write a letter instead. If you write a letter, it must contain all of the information requested in the form and be signed by you or your authorized representative. Incomplete information will delay the processing of your complaint. Employment civil rights complaints will not be accepted through this email address.

Persons with disabilities who require alternative means for communication of program information (Braille, large print, audiotape, etc.), should contact USDA's TARGET Center at (202) 720-2600 (voice and TDD).

Send your completed complaint form or letter to us by mail, fax, or email. Here are our addresses and fax number:

Mail
U.S. Department of Agriculture
Director, Office of Adjudication
1400 Independence Avenue, SW
Washington, DC 20250-9410

Fax
(202) 690-7442

E-mail
program.intake@usda.gov

For help filling out the form, you may call any of these telephone numbers:

(202 260-1026 (Local)
(866) 632-9992 (Toll-free Customer Service)
(800) 877-8339 (Local or Federal relay)
(866) 377-8642 (Relay voice users)

How do I request a waiver of the 180-day filing deadline?

A waiver may be granted for the following reasons: (1) the discriminatory act could not reasonably be expected to be known within the 180-day period; (2) illness or incapacitation; (3) the same complaint was filed with another Federal, state, or local agency; and (4) any other basis determined by the Director of the Office of Adjudication.

Whom may I contact for further information on filing a program discrimination complaint?

You may contact the Office of Assistant Secretary for Civil Rights, Information Research Service, on (866) 632-9992 (toll free) or (202) 260-1026 or send an email to the Office of the Assistant Secretary for Civil Rights at CR-INFO@ascr.usda.gov. Individuals who are deaf, hard of hearing, or have speech disabilities, may contact us through the Federal Relay Service on (800) 877-8339 or (800) 845-6136 (Spanish)..

How is my discrimination complaint processed?
 
Filing a USDA program discrimination complaint does not waive or toll requirements for filing a lawsuit. Complainants are advised that they may wish to consult a lawyer at their earliest convenience to ensure that their rights are protected and preserved.

Intake Stage

The first stage of the program discrimination complaint process is the intake stage. At this stage, the Office of Adjudication determines whether your complaint meets the legal requirements to be accepted for processing. Prior to making this determination, the Office of Adjudication may request clarification or additional information about the complaint from you. For more information about what must be included in your complaint, read How To File A Program Discrimination Complaint.

If your complaint is not accepted for processing, the Office of Adjudication will send you a letter notifying you why your complaint was not accepted and your complaint will be dismissed. If appropriate, your dismissed complaint may be referred to an agency or forum that may assist in resolving the issues. In this case, you will also be notified of the referral.

If your complaint is accepted for processing, the Office of Adjudication will send you a letter to notifying you of the acceptance and inform you of the issues that will be investigated. The USDA agency that your complaint is against will be required to prepare a written statement giving their position regarding your complaint. After the agency's position statement is received, the case will be sent to the next stage, investigation.

Investigation Stage

During the investigation stage, the Office of Adjudication will assign an investigator to the complaint. The investigator will contact you, any agency employees involved, and any other appropriate individual, to obtain sworn statements and documents relating to the issues in the complaint. After the complaint is investigated, a Report of Investigation is prepared and the complaint is sent to the next stage, adjudication. The complainant may obtain a copy of the Report of Investigation, after the complaint is closed, by making a request under the Freedom of Information Act.

Adjudication Stage

During the adjudication stage, the Office of Adjudication will review the Report of Investigation and perform a legal and factual analysis of the complaint to determine whether discrimination occurred. Based on this analysis, the Office of Adjudication will issue a Final Agency Decision. The Final Agency Decision will contain an analysis of the claims in the complaint and the Office of Adjudication conclusions and findings, including whether discrimination was found.

If discrimination is found, the Office of Adjudication may attempt to settle the complaint or take other corrective action, as appropriate. If no discrimination is found, the complaint is closed. A copy of the Final Agency Decision will be mailed to the complainant after it is signed by the Director of the Office of Adjudication.

If your complaint alleges discrimination based on disability, you may appeal the Final Agency Decision to the Assistant Secretary for Civil Rights within 90 days of receipt of the Final Agency Decision. This opportunity for appeal applies only to complaints alleging discrimination based on disability.

Note

In complaints alleging discrimination in certain USDA programs or those falling under the authority of other government agencies or departments, the complaint may be is processed in accordance with a Memorandum of Understanding. In those instances, the procedure used to process your complaint may be different from the procedure described above. The procedure used will be determined by the Memorandum of Understanding.

Presentación de Quejas por Discriminación por Clientes del USDA

USDA prohíbe la discriminación contra sus clientes. Si usted cree que ha sido discriminado al obtener servicios del USDA o al participar en un programa del USDA o un programa que recibe asistencia financiera Federal del USDA, usted puede presentar una queja (querella) al USDA. OASCR, por medio de la Oficina de Adjudicación, investiga y resuelve querellas de discriminación en los programas dirigidos o financiados por USDA.

USDA prohíbe la discriminación a causa de raza, color, religión, sexo, edad, origen nacional, estado civil, orientación sexual, estado de familia/estado de paternidad, discapacidad, conocimiento limitado del inglés, o porque todo o parte de los ingresos de un individuo se deriva de un programa de asistencia pública. En programas que reciben asistencia financiera Federal del USDA, es prohibido la discriminación a causa de raza, color, credo religioso, sexo, afiliación política, edad, discapacidad, origen nacional o conocimiento limitado del inglés. (No todos los criterios prohibidos se aplican a todos los programas.) La represalia por causa de participación previa en un procedimiento de derechos civiles está prohibida.

Personas con impedimentos que requieran medios alternativos de comunicación para obtener información acerca de los programas (Braille, tipografía agrandada, cintas de audio, etc.) deben ponerse en contacto con el Centro TARGET de USDA, llamando al (202) 720-2600 (voz y TDD).

Para radicar una querella por discriminación en algún programa del USDA, por favor completar este formulario: USDA Program Discrimination Complaint Form. Usted o su representante autorizado debe firmar el formulario. No es necesario que usted utilice este formulario. Alternativamente usted puede enviar una carta. Si escribe una carta, la carta tiene que incluir la misma información requerida en este formulario y debe de ser firmada por usted o su representante autorizado. La presentación de información incompleta atrasará el proceso de trámite de su querella.

Envíenos su formulario completado o su carta por correo postal, fax o correo electrónico. Aquí están nuestras direcciones y el número de fax:               

Correo Postal