Payment Security Debt Cancellation Program Agreement

This document contains IMPORTANT INFORMATION about how to qualify for a benefit and why you may not receive a benefit.



Optional Program

  • Your purchase of this Program is optional. You may cancel at any time.
  • Whether or not you purchase this Program will not affect Your credit terms of any existing Credit Card Agreement You have with Us.

Program Cost

  • The monthly Program fee is $1.66 per $100 of Your Account monthly ending balance automatically billed on Your Account statement.

Who is Covered

  • The primary and joint account holders on the Account and any authorized users on the Account.

Making Monthly Payments

  • After a Covered Event happens You must continue to make any required minimum payments on Your Credit Card Account after a Covered Event happens until You are notified Your Benefit request is approved.

Multiple Covered Events

  • If Your Covered Events have the same Benefit Start Date You will need to choose one Covered Event.


2.1 Request Benefit Form

  1. Call 1-800-815-4051
          9:00 A.M. to 9:00 P.M. Eastern Time, Monday through Friday
    Except holidays
    You may also write to Payment Security, P.O. Box 39, Roswell, GA 30077-0039.
  2. Complete and return Benefit request form with requested documents within one (1) year of the Benefit Start Date.
  3. Requests for benefits for Covered Events of authorized users must be submitted by the primary or joint account holder.

2.2 Other Required Documents

We may ask You to provide additional information or documents as we review Your Benefit request form request.

2.3 Filing Period

Return completed Benefit request form and required documents within one (1) year from the Benefit Start Date.


Please read about each of the Covered Events and the exclusions

3.1 Job Loss, Leave of Absence and Disability

To obtain a Job Loss or Leave of Absence Benefit:

Excluded Reasons:

You cannot obtain a Job Loss or Leave of Absence Benefit if You:

To obtain a Disability Benefit:

Cancellation amount for Job Loss, Leave of Absence and Disability Covered Events:

3.2 End of Self-Employment or Contract Employment or Reduction of Hours

  • To obtain an End of Self-Employment or Contract Employment or Reduction of Hours Benefit:

  • Cancellation amount for End of Self-Employment or Contract Employment or Reduction of Hours Covered Event:

    3.3 Hospitalization and Nursing Home Care

    To obtain a Hospitalization or Nursing Home Care Program Benefit:

    Cancellation Amount for Hospitalization and Nursing Home Care:

    3.4 Terminal Medical Condition or Loss of Life

    To obtain a Terminal Medical Condition or Loss of Life Benefit:

    Cancellation Amount for Terminal Medical Condition or Loss of Life Protection:

    4.0 End of this Agreement

    4.1 Reasons Agreement May End

    1. We may end this Agreement at any time by giving You written notice at the last address We have for You on record.
    2. This Agreement will end without notice, if:
      • a) You do not make any part of the required minimum payment on Your Account for 3 billing periods in a row;
      • b) You file for bankruptcy; or
      • c) Your Account has been closed for additional purchases and You have repaid any Account balance.
    3. We may also end this Agreement by written notice if You submit a fraudulent Benefits request.
    4. If You cancel this Agreement.

    4.2 Re-Enrollment

    If this Agreement is ended, You will not be able to take part in the Program again unless You submit a new enrollment request and We approve it.


    5.1 Medical Records

    You agree that We have the right, at Our own cost, to look at the primary and joint account holder's, or authorized user's, as applicable, medical records in connection with any request for a Benefit for Disability, Nursing Home Care, Hospitalization or Terminal Medical Condition. We will not enforce this right any more than is allowed by the applicable laws.

    5.2 Eligible Doctors

    Any requirement about a doctor must be met by a doctor of medicine or osteopathy licensed in the U.S. The doctor cannot be Yourself or a member of Your immediate family.

    5.3 Tax Implications

    A Benefit may be taxable as income. You should contact a qualified tax advisor concerning the tax impact.

    5.4 Waiver

    We reserve the right to waive any of the requirements in this Agreement. However, if We do so, We will not be obligated to waive the same requirements in any other situation. Our waiver of any requirement will not be a waiver of any other requirement.

    5.5 Credit Card Agreement

    This Agreement is made a part of Your Credit Card Agreement. Your Credit Card Agreement remains in full force and effect.

    If there is a conflict between this Agreement and Your Credit Card Agreement, this Agreement will control.

    5.6 Change in Terms

    We may change or add to the terms of this Agreement at any time. We will provide you notice as required by law. If a change is not favorable we will provide you with notice and the right to cancel before the change takes place.

    5.7 Availability

    The Program may not be available in all states.

    5.8 Arbitration

    Any Dispute and Claim Resolution provisions (Including Arbitration) that may apply with respect to Your Credit Card Agreement shall also apply with respect to the Program.

    5.9 Assignment

    We may assign any of our rights or obligations under this Agreement without notice to you. You may not assign any of your rights or obligations under this Agreement.


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