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PLATFORM AND PORTAL TERMS OF USE

Last Updated: January 26, 2026

 

These Platform and Portal Terms of Use ("Platform Terms") govern access to and use of Claiminformatics, Inc. ("Claiminformatics," "we," "us," or "our") authenticated platforms, portals, applications, and tools, including without limitation: customer portals, CLEAR™, PAIR™, fiduciary compliance tools, analytics dashboards, reports, integrations, APIs, and any related software and services (collectively, the "Platform").

 

By accessing or using the Platform, you agree to be legally bound by these Platform Terms. If you do not agree, do not access or use the Platform.

 

1. Important Disclosures – No Legal Advice; No Fiduciary or Professional Services

Claiminformatics is not a law firm and does not provide legal advice, legal services, or representation. Claiminformatics does not provide fiduciary advice or assume fiduciary duties, and does not provide actuarial, accounting, tax, clinical, medical, or other regulated professional advice.

 

The Platform and all outputs, reports, findings, flags, recommendations, scores, benchmarks, educational content, and other materials (collectively, "Outputs") are provided solely for informational and operational purposes to support internal review, oversight, and workflow decisions. Outputs may be based on the data you provide and may not reflect all relevant facts, contracts, plan terms, policies, or legal requirements.

 

You acknowledge and agree that:

  • You are solely responsible for determining how (and whether) to use Outputs, and for independently evaluating and verifying any findings;

  • You are solely responsible for all fiduciary, legal, compliance, operational, and business decisions, including decisions under ERISA or other laws;

  • Claiminformatics does not guarantee that the Platform or Outputs will identify all issues, comply with every applicable requirement, or achieve any particular outcome, savings, recovery, or result;

  • Use of the Platform does not create an attorney-client relationship, fiduciary relationship, advisory relationship, or other special relationship between you and Claiminformatics.

You should consult qualified legal counsel and other professional advisors as appropriate.

 

1. No Legal, Fiduciary, or Professional Advice

Claiminformatics is not a law firm and does not provide legal advice, fiduciary advice, actuarial advice, medical advice, accounting advice, tax advice, or any other regulated professional advice.

 

The Platform, including all outputs, reports, analytics, flags, findings, benchmarks, recommendations, educational materials, and other information generated or made available through the Platform (collectively, "Platform Outputs"), is provided solely for informational, analytical, and operational support purposes.

 

Platform Outputs are not a substitute for independent professional judgment and must not be relied upon as legal advice, fiduciary determinations, regulatory guidance, or guarantees of compliance, savings, recoveries, outcomes, or results.

 

You acknowledge and agree that:

  • Claiminformatics does not assume any fiduciary role or duty with respect to your plan, organization, participants, or beneficiaries;

  • Use of the Platform does not create an attorney-client relationship, fiduciary relationship, advisory relationship, or any other professional relationship;

  • You remain solely and exclusively responsible for all fiduciary decisions, legal determinations, compliance obligations, interpretations of law or contract, and actions taken or not taken based on Platform Outputs.

 

2. Relationship to Other Agreements

If you or your organization has entered into a Master Services Agreement, Order Form, Statement of Work, subscription agreement, Business Associate Agreement ("BAA"), or similar agreement with Claiminformatics (collectively, "Customer Agreements"), those agreements govern in the event of a conflict. These Platform Terms apply to the extent not inconsistent with the applicable Customer Agreements.

 

3. Authorized Users and Accounts

Access to the Platform is limited to authorized business users ("Authorized Users"). You are responsible for:

  • Ensuring each Authorized User has a legitimate, job-related business need for access;

  • Maintaining the confidentiality and security of all credentials;

  • Promptly revoking access when it is no longer required or appropriate;

  • All activity conducted under your accounts, whether authorized or unauthorized.

 

Shared credentials are strictly prohibited.

 

4. License and Permitted Use

Subject to compliance with these Platform Terms and any applicable Customer Agreements, Claiminformatics grants you a limited, revocable, non-exclusive, non-transferable, non-sublicensable license to access and use the Platform solely for your internal business purposes and only by Authorized Users.

 

Platform outputs may be used for internal operations, plan oversight, vendor management, compliance support, and other permitted healthcare operations, subject to applicable law and contract.

 

5. Proprietary Technology and Trade Secrets

5.1 Ownership

The Platform and all underlying technology, including but not limited to edits, algorithms, rules engines, scoring methodologies, workflows, benchmarks, data models, logic, and system behavior (collectively, the "Proprietary Technology"), are the exclusive property and trade secrets of Claiminformatics. No ownership rights are transferred by virtue of Platform access or use.

 

5.2 Prohibited Conduct

You shall not, and shall not permit any Authorized User or third party to:

  • Reverse engineer, decompile, disassemble, decode, or otherwise attempt to derive the source code, logic, structure, or underlying algorithms of the Platform;

  • Analyze, benchmark, scrape, probe, or observe Platform behavior for the purpose of replicating, approximating, documenting, or reconstructing Proprietary Technology;

  • Use automated tools, scripts, bots, or extraction techniques to infer or catalog Platform logic or behavior;

  • Use Platform outputs, observations, or derived information to develop, enhance, validate, or support any competing product or service;

  • Disclose non-public Platform logic, methodologies, workflows, or Proprietary Technology to any third party.

 

Any violation of this Section constitutes a material breach and causes irreparable harm for which monetary damages would be inadequate.

 

6. PHI, HIPAA, and Privacy

The Platform may provide access to Protected Health Information ("PHI"). All access to and use of PHI must comply with HIPAA, the HITECH Act, applicable state privacy laws, and any BAA between the parties.

 

PHI access is strictly limited to Treatment, Payment, and Health Care Operations and must comply with the minimum necessary standard.

Personal lookups, access for curiosity or non-business purposes, and any unauthorized access to PHI are strictly prohibited. All Platform activity may be logged, monitored, and audited.

 

7. Monitoring, Audits, and Enforcement

Claiminformatics may monitor Platform use, review audit logs, investigate suspected violations, and take appropriate enforcement actions, including immediate suspension or termination of access, where there is suspected misuse, security risk, intellectual property risk, or legal or regulatory requirement.

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You agree to cooperate fully with audits and investigations relating to Platform use and compliance with these Platform Terms.

 

8. Data Rights

As between you and Claiminformatics, you retain rights to data you submit to the Platform, subject to the licenses granted herein and in applicable Customer Agreements.

 

You grant Claiminformatics the right to host, store, process, analyze, and use such data as necessary to provide, secure, maintain, and improve the Platform, generate outputs, comply with legal obligations, and perform contractual obligations.

 

To the extent permitted by law and applicable agreements, Claiminformatics may create and use de-identified and aggregated data derived from Platform data for analytics, benchmarking, quality improvement, and product development.

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9. CLEAR and Document Uploads

For contract review, document ingestion, or similar tools:

  • You represent and warrant that you have all necessary rights and authority to upload and analyze documents;

  • You remain responsible for compliance with any confidentiality, licensing, or contractual restrictions applicable to such documents;

  • Platform outputs are intended to assist operational review and oversight and do not replace independent review or judgment.

 

10. Acceptable Use

You agree not to:

  • Use the Platform in violation of any applicable law or regulation;

  • Interfere with Platform security, integrity, or availability;

  • Upload or transmit malware, spyware, or harmful code;

  • Misuse Platform outputs or attempt prohibited competitive activity;

  • Remove, obscure, or alter proprietary notices.

 

11. Suspension and Termination

Claiminformatics may suspend or terminate Platform access, in whole or in part, immediately upon a material breach of these Platform Terms, misuse of PHI, attempted reverse engineering, competitive misuse, or threats to Platform security or intellectual property.

 

12. Disclaimers

THE PLATFORM IS PROVIDED "AS IS" AND "AS AVAILABLE." TO THE MAXIMUM EXTENT PERMITTED BY LAW, CLAIMINFORMATICS DISCLAIMS ALL WARRANTIES, WHETHER EXPRESS OR IMPLIED, INCLUDING WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, AND NON-INFRINGEMENT.

 

13. Limitation of Liability

TO THE MAXIMUM EXTENT PERMITTED BY LAW, CLAIMINFORMATICS SHALL NOT BE LIABLE FOR ANY INDIRECT, INCIDENTAL, CONSEQUENTIAL, SPECIAL, EXEMPLARY, OR PUNITIVE DAMAGES. CLAIMINFORMATICS’ TOTAL LIABILITY ARISING OUT OF OR RELATING TO THE PLATFORM OR THESE PLATFORM TERMS SHALL NOT EXCEED THE FEES PAID FOR THE PLATFORM IN THE TWELVE (12) MONTHS PRECEDING THE EVENT GIVING RISE TO THE CLAIM.

 

14. Indemnification

You agree to indemnify, defend, and hold harmless Claiminformatics and its officers, directors, employees, and agents from and against any claims, damages, losses, liabilities, costs, and expenses (including reasonable attorneys’ fees) arising out of or related to:

  • Your or your Authorized Users’ access to or use of the Platform;

  • Any violation of these Platform Terms;

  • Any unauthorized access to or misuse of PHI;

  • Any data or materials you submit to the Platform.

 

15. Governing Law and Venue

These Platform Terms are governed by the laws of the State of Connecticut, without regard to conflict-of-law principles. Venue shall lie exclusively in the state or federal courts located in Hartford, Connecticut.

 

16. User Attestation

By accessing or using the Platform, each Authorized User acknowledges and agrees that they have read, understand, and will comply with these Platform Terms, including restrictions relating to PHI access, proprietary technology, reverse engineering, and competitive use.

 

17. Contact

ClaimInformatics, Inc.
Phone: 860.761.9570
Address: 811 Blue Hills Avenue, Bloomfield, CT 06002

 

BY ACCESSING OR USING THE PLATFORM, YOU ACKNOWLEDGE THAT YOU HAVE READ, UNDERSTAND, AND AGREE TO THESE PLATFORM TERMS.

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