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Workers Compensation Alternative Delivery Directions

For Workers Compensation cases in each of the following states: NY, NJ, OR, NC, ARK, WISC, WA, Washington D.C. KY, OK, MI, MN, PA, KS, 1st Choice Funding has spearheaded and has been instrumental in modifying payment delivery methods, which must be accomplished because without such lawsuit funding could not occur. Lawsuit Funding is dependant on such factors as 1. you have an undisputed WC claim and 2. Your insurance companies level of cooperation. While 1st Choice Funding can make no guarantees, modifications of future lump sum payment can make it possible to receive funding NOW when you most need to survive the lenghty litigation process.

Please carefully follow the steps outlined in order to achieve lawsuit funding.

Print These Instructions Then Follow Then Exactly As Outlined

Check When This Step is Complete_____________ Step 1. Contact your Insurance Company Adjuster or Workers Compensation Office, ask them to send (email or fax preferably) the State Approved "Alternative Delivery Form" or the "Modified Delivery Payment Form", (this is the form that provides the authority for you to change the final lump payment you receive sending such to your attorney instead if you. If they don't have a form by this name tell them this is what you are looking to do and ask them to send to you ASAP the form or letter you need to sign to change the way youy receive final payment).

Check When This Step is Complete______________Step 2. When you have the Alternative Delivery Form Completed submit to your insurance company adjuster along with the following letter. Copy & Print this letter on a seperate paper as this has to be completed by the insurance company and returned ASAP.

THIS LETTER MUST BE COMPLETED BY YOUR INSURANCE COMPANY. COPY & PRINT THE LETTER AND ASK YOUR ADJUSTER TO COMPLETE AND RETURN SIGNED ON LETTERHEAD

(begining of letter)

I as a representative of_____________________________________________ hereby agree to forward all cash settlement proceeds issued to_________________________________________ to claimants attorney__________________________________________ of________________________________________________________Law Firm. As the recipient of the claimants settlement proceeds, if and when a cash settlement is agreed upon between the claimant_________________________________and____________________________________________ , at such time all settlement monies shall be distributed according to these directives which I hereby state I received written authorization from the claimant__________________________________ regarding these instructions. This agreement has full force and effect of the law. I acknowledge this payment modification request was issued from the claimant__________________________________to me and as such I will execute per the terms of these directions any and all money if and when a cash settlement is issued to claimant according to these directives.

Date__________________

_______________________________________ (Insurance Company Authorized Agent)

(end of letter)

Check When This Step is Complete______________Step 3. After receiving the executed modification agreement AND THIS LETTER, submit to 1st Choice Funding preferably by fax to 800.839.0939 ext 300 or 775.258.5387 or email: application.services(at@)1stchoicefunding.com.

Check When This Step is Complete______________Step 4. Complete the lawsuit funding application located at http://1stchoicefunding.com/lawsuit-loan-app.html

Check When This Step is Complete______________Step 5. Follow the directions you receive in order to ensure your attorney provides the informaiton we will request so you can obtain funding as soon as possible.

Check When This Step is Complete______________Step 6. As soon as we have your file you will receive a contract usually within 2-3 working days. When you do you and your attorney will execute the agreement and money will be available within 1 business day in most instances.