Visa Liability Waiver Client Toolkit

Visa U.S.A. Inc.

Security and coverage when providing Visa Business and Commercial cards to employees

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Now you can provide Visa Business and Commercial cards to employees with built-in protection

against losses.

Safeguards for providing Visa cards to eligible cardholders

Visa® Liability Waiver is one of the most valuable core beneﬁts of Visa Business and Commercial

cards – oﬀering the security and coverage you need to do business with complete conﬁdence.

Visa Liability Waiver insures you against eligible losses that might be incurred through card misuse

by a terminated eligible cardholder. In the event that an eligible cardholder misuses Visa Business or

Commercial card privileges, Visa Liability Waiver waives certain eligible charges and helps minimize

your losses.

Visa Liability Waiver beneﬁts:

• Coverage up to $100,000 per eligible cardholder

• Automatic enrollment for clients

• No deductible and no extra cost to clients

• No maximum cap per client

• Coverage of cash advances, oﬃcers, and ghost accounts

• Simpliﬁed claim procedures for clients

Visa Conﬁdential: This document contains Visa’s proprietary information for use by Visa issuers, their clients, and their processors solely in support of Visa card programs.

Disclosure to third parties or any other use is prohibited without prior written permission of Visa Inc.

Security. Coverage. Confidence.

Visa Liability Waiver gives you safeguards and protection that are built right in. That means you can

provide employees with Visa Business and Commercial cards with full conﬁdence – and that makes

doing business easier and more convenient.

This Visa Liability Waiver Client Toolkit provides program details, describes the materials you will need,

and includes step-by-step instructions for handling claims.

What charges are eligible for coverage?

Waivable Charges

Waivable charges are charges incurred by an eligible cardholder or other authorized person that:

• Do not beneﬁt the company directly or indirectly; or

• Beneﬁt the company directly or indirectly when the eligible cardholder was

reimbursed by the company for those charges and failed to pay the ﬁnancial

institution; and

• Are the responsibility of the company and/or eligible cardholder for payment to

its ﬁnancial institution

Charges may be:

• Billed up to 75 days before the Notiﬁcation of Termination Date;

• Incurred but unbilled as of the Notiﬁcation of Termination Date; or

• Incurred up to 14 days after the Notiﬁcation of Termination Date

Cash Advances

• Prior to the Notiﬁcation of Termination Date, cash advances are considered waivable

charges as deﬁned; or

• After the Notiﬁcation of Termination Date, cash advances are considered waivable

charges as deﬁned and limited to $300 per day or a maximum of $1,000

Notiﬁcation of Termination Date means the date the cardholder gives to his/her employer or receives from his/her employer oral or written notice of immediate or

pending termination, or the date the cardholder leaves his/her employer, whichever is earlier.

Account must be canceled within two (2) business days following the Notiﬁcation of Termination Date.

Visa Conﬁdential: This document contains Visa’s proprietary information for use by Visa issuers, their clients, and their processors solely in support of Visa card programs.

Disclosure to third parties or any other use is prohibited without prior written permission of Visa Inc.

Protect your business with

essential safeguards

The following items can be downloaded from Visa Online®.

Visa Business and Commercial Credit Card Liability Waiver Program Outline

This document details the speciﬁcs of the program as they pertain to Visa Business and Commercial

credit card charges, outlining permitted waivable charges, obligations of the company and ﬁnancial

institution, and payment of claims.

Visa Business Debit Card Liability Waiver Program Outline

This document outlines the program as it pertains to Visa Business Debit Card charges.

Visa Liability Waiver Aﬃdavit of Waiver Claim Form

To request a waiver of charges, you must complete the Company section of the Aﬃdavit of Waiver

claim form, sign it, and submit it to the card-issuing ﬁnancial institution.

Sample Account Cancellation Request

To comply with the Visa Liability Waiver obligations, you must send the card-issuing ﬁnancial

institution a letter requesting cancellation of the account. This letter must be sent within two (2)

business days of the Notiﬁcation of Termination Date to remain eligible for the total waiver period.

Sample Employee Account Cancellation Notiﬁcation Letter

Employers participating in the Visa Liability Waiver beneﬁt are obligated to quickly notify former

employees, in writing, that their account has been canceled and they no longer have the right to use

it. This letter can be sent by ﬁrst-class mail or fax. You should retain a copy, as it must be attached to

your Aﬃdavit of Waiver claim form in the event a claim is ﬁled.

Visa Conﬁdential: This document contains Visa’s proprietary information for use by Visa issuers, their clients, and their processors solely in support of Visa card programs.

Disclosure to third parties or any other use is prohibited without prior written permission of Visa Inc.

Visa Liability Waiver Materials

“Account Cancellation Request.”

If the card is not canceled within two (2) business days, only charges billed for up to 75 days prior to the Notiﬁcation of Termination Date will be eligible.

“Employee Account Cancellation Notiﬁcation Letter.”

For claims of this type over $5,000.

Once a claim has been paid for a given person, no future claims will be considered.

Visa Conﬁdential: This document contains Visa’s proprietary information for use by Visa issuers, their clients, and their processors solely in support of Visa card programs.

Disclosure to third parties or any other use is prohibited without prior written permission of Visa Inc.

Your company may request that your Visa card-issuing ﬁnancial institution waive liability for waivable

charges when you meet all of the following requirements:

1. Terminate, voluntarily or involuntarily, a Visa Business or Commercial cardholder’s employment.

2. Have one (1) or more valid Visa Business or Commercial card accounts in good standing.

3. Request the ﬁnancial institution to cancel the account

within two (2) business days of the

Notiﬁcation of Termination Date.

4. You deliver to the employee or send by ﬁrst-class mail or fax a written notice

stating that the

account has been canceled and that the employee should immediately discontinue all use of the

card, pay any outstanding amounts, and return the card to your company.

5. Complete the Company side of the Aﬃdavit of Waiver claim form, have an authorized oﬃcial

of your company sign it, and return it within ninety (90) days of the employee’s Notiﬁcation of

Termination Date to the ﬁnancial institution. All claim documents must be ﬁled with the program

underwriter within one hundred eighty (180) days from the Notiﬁcation of Termination Date.

6. Include the following documentation with the Aﬃdavit of Waiver claim form when sending it to

the ﬁnancial institution:

• Copy of the Eligible Cardholder Account Cancellation Notiﬁcation Letter

• Description of the waivable charges (e.g., a copy of the account statement

with the waivable charges highlighted)

• Proof of reimbursement (e.g., expense reports or canceled checks) in cases

where the employee was reimbursed by the company but failed to pay the

ﬁnancial institution.

7. You give prompt written notice to the ﬁnancial institution in cases where it invoices the eligible

cardholder directly, if you know that an eligible cardholder is receiving reimbursement for charges

but is not paying the ﬁnancial institution for those charges.

8. Remit to the ﬁnancial institution any amounts recovered for waived charges from any source after

ﬁling an Aﬃdavit of Waiver claim form and agree to assign any rights to collect such amounts from

the employee to the program underwriter.

Simple requirements to filing a claim

Visa Business or Commercial Card Aﬃdavit of Waiver Claim Form

Company

This form must be returned to the Financial Institution within 90 days of Notiﬁcation of Termination.

Company Information

Company Name

Has a claim for this charge been submitted under any other insurance policy?

Yes No

Are you or the company aware of any prior dishonest acts committed by this

employee? Yes No

Date Account Cancellation Notiﬁcation Letter sent to employee ____________

Please refer to the complete description of program requirements in the

Visa Liability Waiver Program Client Toolkit and Program Outline.

Street Address

City State ZIP

Contact Person

Contact Phone

Date of Account Cancellation Request to Issuing Financial Institution (MM/DD/YY)

Employee Information

Employee Name

Notiﬁcation of Termination Date ______________________________________

Termination Date _________________________________________________

Is the Employee an:

Owner Partner Principal Shareholder

None of the Above

Transaction Type:

Does Not Beneﬁt Company $ _____________________________________

Employee Reimbursed but Failed to Pay Account $ ____________________

Total Amount of Submitted Waivable Charges $ _________________________

Please refer to the complete description of program requirements in the

Visa Liability Waiver Program Client Toolkit and Program Outline.

Street Address

City State ZIP

Phone

Social Security Number

Account Number

Type of Card:

Visa Business Credit Card Visa Signature Business

Visa Business Debit Card Visa Purchasing Card

Visa Corporate Card

Visa Large Purchase Advantage Card

Card Issue Date (MM/DD/YY) Employee Hire Date (MM/DD/YY)

Request for Waiver of Charges

I wish to certify that the above named Cardholder was an employee of ________________________________________ (Company Name). According to the terms

of the policy, the above named former employee has used his/her card to make unauthorized transactions, or cash advances, which did not beneﬁt our Company, or

has received reimbursement for Company expenses but failed to render payment to the account in the amount of $_________________________ as detailed above.

As __________________________________ (Company Name) is liable for these charges under the agreement with ______________________________________

(Financial Institution), we request a waiver of the charges under the terms and conditions of the policy. Furthermore, if the Company recovers any amounts for the

waived charges from any source after the Company has requested a waiver of the transactions, the Company will remit all such recoveries to the Financial Institution.

The Company agrees to assign any rights it may have to collect such amounts from the Cardholder to the Program Underwriter for Visa claims.

I CERTIFY THAT ALL OF THE ABOVE INFORMATION IS ACCURATE.

Signature _______________________________________________________________________ Date _____________________________________________

Printed Name ____________________________________________________________________ Title _____________________________________________

Claim Processing Checklist (Prior to Submission)

You Must: Complete every question on this form (incomplete forms will be returned) Sign and date this form

Attach:

Employee Account Cancellation Notiﬁcation Letter

Copy of statement with Waivable Transactions highlighted (must equal amount claimed)

For claims over $5,000, proof of reimbursement in cases where the employee was reimbursed but failed to pay the Financial Institution

(examples of proof would include expense reports or canceled checks)

continued on next page

Visa Liability Waiver Client Toolkit

Visa Liability Waiver

Visa Conﬁdential: This document contains Visa’s proprietary information for use by Visa issuers, their clients, and their processors solely in support of Visa card programs.

Disclosure to third parties or any other use is prohibited without prior written permission of Visa Inc.

Visa Liability Waiver Client Toolkit

Visa Business or Commercial Card Aﬃdavit of Waiver Claim Form (cont.)

Issuer

This form must be ﬁled with the Program Underwriter within 180 days of Notiﬁcation of Termination.

Issuer Information

Issuer Name

Amount of Transactions Submitted by the Company (1) $ ______________

Amount Recovered to Date (2) $ ______________

Total Amount Claimed (Lines 1–2) $ ______________

Must Be Equal To or Less Than Amount Claimed by Company (Line 1)

Credit Cards Only:

Cardholder’s Credit Limit $ __________________________________________

Is the Company Responsible for Charges under the Company Agreement?

Yes No

Is the Cardholder Responsible for Charges under the Cardholder Agreement?

Yes No

Is this Claim the Result of a Lost/Stolen Card?

Yes No

If Yes, Date Reported _______________________________________________

Is this Claim the Result of a Bankruptcy/Insolvency?

Yes No

If Yes, Date Declared _______________________________________________

Credit Cards Only:

Has the cardholder sent a check for payment on this account within the last

12 months which was uncollectible? Yes No

Please refer to the complete description of program requirements in the

Visa Liability Waiver Program Client Toolkit and Program Outline.

Street Address

City State ZIP

Contact Person

Contact Phone

Total Number of Valid Company Accounts

Collection Information

Name of Collection Agency

Street Address

City State ZIP

Contact Person

Contact Phone

Date Assignment Made (MM/DD/YY)

Date Account Cancellation Request Received (MM/DD/YY)

Date of Account Cancellation on Base (MM/DD/YY) Date Aﬃdavit of Waiver Claim Form Received (MM/DD/YY)

Recovery of Funds Certiﬁcation

I certify that should any amount be recovered by ________________________________________ (Financial Institution) or any other source with respect to

Waivable Charges, we agree to use these funds to reduce the Waivable Charges and/or the amount of any claim ﬁled with the Visa Liability Waiver Program, or

if the claim payment has previously been submitted to us, we shall return such amounts to the Program Underwriter for Visa claims.

I CERTIFY THAT THE ABOVE INFORMATION IS ACCURATE.

Signature _______________________________________________________________________ Date _____________________________________________

Printed Name ____________________________________________________________________ Title _____________________________________________

Claim Processing Checklist (Prior to Submission)

You Must:

Complete every question on this form (incomplete forms will be returned) Sign and date this form

Attach:

Account Cancellation Request Proof Cardholder Agreement with Financial Institution

Company Agreement with Financial Institution Detailed Description of Collection Eﬀorts

Statement/Print Screens with billing date, balance, and account termination date highlighted

For claims over $5,000, proof of reimbursement in cases where the employee was reimbursed but failed to pay the Issuer

(examples of proof would include expense reports or canceled checks)

Note: At any time, Visa and/or its Program Underwriter may request further documentation regarding proof concerning the charges in question.

Visa Liability Waiver

Please Send To: Visa Program Underwriter, c/o Liability Waiver – ESIS, P.O. Box 5129, Scranton, PA 18505-0568

Phone: (888) 518-5665 Fax: (800) 503-7107 Email: liabilitywaiverprogram@esis.com

Visa Conﬁdential: This document contains Visa’s proprietary information for use by Visa issuers, their clients, and their processors solely in support of Visa card programs.

Disclosure to third parties or any other use is prohibited without prior written permission of Visa Inc.

Visa Liability Waiver Client Toolkit

Sample Visa Business or Commercial Card Account Cancellation Request

Visa Business or Commercial Card Client Name

Company

Address

City, State, ZIP (or Letterhead)

Date

Financial Institution Representative

Financial Institution Name

Address

City, State, ZIP

Re: Request for Cancellation of Visa Business or Visa Commercial Card Account for Covered Employee

To Whom It May Concern:

The below-named cardholder gave or received oral or written notiﬁcation of termination on this date (e.g., MM/DD/YY) ____________ .

Account Number __________________________________________ Phone __________________________________________

Cardholder’s Name ___________________________________________________________________________________________

Home Address ______________________________________________________________________________________________

City _____________________________________________________ State ______________________ ZIP _______________

We hereby request that this account be canceled immediately.

We understand that to request a waiver of charges, if any, on the above numbered account, we must ﬁle a Visa Aﬃdavit of Waiver claim

form within 90 days of the Notiﬁcation of Termination Date.

Please be further advised that:

___ The company was billed for the cardholder’s charges.

___ The cardholder was billed directly and has been contacted in writing and directed to immediately pay all outstanding charges.

Our company ___ has /___ has not retrieved the Visa Business or Commercial card from the cardholder. The card ___ is /___ is not

enclosed.

Sincerely,

Signature

Title (must be a corporate oﬃcer)

Visa Liability Waiver

Visa Conﬁdential: This document contains Visa’s proprietary information for use by Visa issuers, their clients, and their processors solely in support of Visa card programs.

Disclosure to third parties or any other use is prohibited without prior written permission of Visa Inc.

Visa Liability Waiver Client Toolkit

Sample Visa Business or Commercial Card Employee Account Cancellation Notiﬁcation Letter

Visa Business or Commercial Card Client Name

Company

Address

City, State, ZIP (or Letterhead)

Date

Employee Name

Address

City, State, ZIP

Dear Employee Name:

Please be advised that we have canceled your Visa Business or Visa Commercial card account number __________________________

and that your rights to use the card have ended. Immediately discontinue all use of the card, and return it to us if you have not already

done so.

In addition, you must immediately pay any outstanding balance that you owe on the card.

Thank you for your cooperation in this matter.

Sincerely,

Authorized Signature

Visa Liability Waiver

Visa Conﬁdential: This document contains Visa’s proprietary information for use by Visa issuers, their clients, and their processors solely in support of Visa card programs.

Disclosure to third parties or any other use is prohibited without prior written permission of Visa Inc.