BEGINNERS EDGE SPORTS TRAINING, LLC (3)

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❑D ro❑actual losses were inciired dimming tiu eEperience period. Tins i❑ypotiutical rating calcnation is pronded for informational p0rposes only. Dispute Process Yo❑ may dispi to oil actions or tiu actions of tiu WCIRB piers❑ant to CIC Sections 11 ❑3❑ and 11 ❑iE3.1. A. Our Dispute Resolution Process. Yo❑ may send u a written Complaint and Re❑❑est for Action re❑lusting that we reconsider a cunge in a classification assignment tut resnts in an increased premiiE n and/or re❑lusting tut we renew tiu manner in wnc❑ oil- rating system us iuen applied in connection wit❑ tiu ins:l-ance afforded or offered you Written Complaints and Re❑lists for Action s0nd Fie forwarded to❑ Hartford Casualty Insurance Company One Pointe Drive, Suite 200, Brea, CA 92821; Telephone (800) 451-6944; Fax (860) 723-4289. After yoi❑ send yoi- Complaint and Re❑❑est for Action, we lulu 30 days to send yo❑ a written notice indicating wutiur yoi written re❑lust will iu renewed. If we agree to renew yoi re❑lust, we mint condiut to renew and issiu a decision granting or re�octing yoi- re❑lust witinn 60 days after sending yo❑t❑e written notice granting renew. If we decline to reinew yoi-i- re❑list, if yo❑ are dissatisfied wit❑ tiu decision Egon reinew, or if we fail to grant or re:ect yoi r rei❑i Ost or issiu a decision —pon reinew, yo❑ may appeal to tEe Insi-i-ance Commissioner as descriiud in paragrap❑ II.C., Mow. B. Disputing the Actions of the WCIRB. If yo❑ uu ❑een aggrieud ❑y any decision, action, or omission to act of tiu WCIRB, yo❑ may re❑list, in writing, tut tiu WCIRB reconsider its decision, action, or omission to act. Yo❑ may also re''❑❑est, in writing, tut tlu WCIRB renew tiu manner in wnc❑ its rating system us iuen applied in connection wit❑ tiu ins0rance afforded or offered yoi For re❑lusts related to classification dispi tes, to reporting of ei[perience, or courage issius, yoi initial re —lust for renew milt iu receiud Ey tiu WCIRB witnn 12 montiu after tiu ei[piration date of tlu policy to wnc❑ tiu re❑list for renew pertains, eiuept if tiu re❑lust in!ulus tiu application of tiu Rension of Losses rive. For re —lists related to yo:lr ei[perience modification, yoi initial re❑list for reinew mint a receiud i❑y tiu WCIRB witnn 6 montiu after tiu issuance, or 12 montiu after tiu eEpiration date, of tiu e�j)erience modification to wnc❑ to re —lust for reinew pertains, wnci❑eur is later, eiuept if to re❑list for reinew inulus to application of tiu Rension of Losses rive. If tiu re❑lust inulius tiu Reinsion of Losses rive, tiu time to state yoi- appeal may iu longer. :See Section ❑I, Rne ❑oftu ERP❑ Yo❑ may commence to renew process i❑y sending tiu WCIRB a written In❑nry. Written In❑nries siund iu sent toi❑WCIRB, One Montgomery Street, Suite 400, San Francisco, CA 94104, Attn: Customer Service. Customer Service can be reached at 888.229.2472 (phone), 415.778.7272 (fax) and customerservice(&wcirb.com (email). If yo❑ are dissatisfied wit❑ to WCIRB19 decision —pon an In❑inry, or if tlu WCIRB fails to respond witinn 90 days after receipt of to In❑inry, yo❑ may pijsiu tiu s❑i❑:Oct of tiu In❑inry i❑y sending tiu WCIRB a written Complaint and Re❑i— st for Action. After yo❑ send yoi - Complaint and Re❑i❑est for Action, tiu WCIRB us 30 days to send yo❑written notice indicating wiutur yoij written re❑list will iu renewed. If tiu WCIRB agrees to reinew yoFir re❑lust, it mint condiut to renew and issiu a decision granting or reFecting yoij re❑lust witnn 60 days after sending yo❑ tiu written notice granting reinew. If to WCIRB declines to renew yoij re❑list, if yo❑ are dissatisfied wit❑ tiu decision ikon renew, or if tlu WCIRB fails to grant or re:ect yoij re❑list or issiu a decision —pon reinew, yo❑ may appeal to tiu Insiance Commissioner as descriiud in paragrap❑ II.C., iulow. Written Complaints and Re❑❑ests for Action siEond ❑e forwarded to❑WCIRB, One Montgomery Street, Suite 400, San Francisco, CA 94104, Attn: Complaints and Reconsideration. The WCIRB's contact information is 888.229.2472 (phone), 415.371.5204 (fax) and customerservice(&-wcirb.com (email). C. California Department of Insurance - Appeals to the Insurance Commissioner. After yo❑ follow tiu appropriate dispi❑te resoliEtion process descriiud aiuu, if :1 ❑we or tiu WCIRB decline to reinew yoEir re❑lust, -2❑yo❑ are dissatisfied wit❑ t❑e decision ikon renew, or :3❑we or tlu WCIRB fail to grant or re:ect yoiEr rei❑rust or issiu a decision ikon reinew, yo❑ may appeal to tiu Instance Commissioner pEirsunt to CIC Sections 11 ❑Yq 11 ❑i .6, 11 ❑❑3.1 and Title 10, California Code of Reg:lations, Section 2i❑09.40 et se:1 Yoi❑ mint file yoi - appeal witinn 30 days after we or tiu WCIRB send yoi❑ tiu notice re:ecting reinew of yoEr Complaint and Rei❑❑est for Action or tiu decision ikon yoi Complaint and Re❑i❑est for Action. If no written decision regarding yoi Complaint and Re❑Cest for Action is sent, yoi appeal mut iu filed witinn 120 days after yo❑sent yoij Complaint and Re❑i❑est for Action to iu or to tiu WCIRB. Ti❑e filing address for all appeals to t❑e Insurance Commissioner is❑ Form PN 04 99 01 J (06/25) Printed in ❑.S.A. Page 2 of 3