By accessing or using Claim Knight (the "Service") operated by Palmetto Health Pro, LLC, doing business as Happy Health Agency ("Company," "we," "us," or "our"), you ("User," "you," or "your") agree to be bound by these Terms of Service ("Terms"). If you do not agree to these Terms, do not use the Service.
If you are using the Service on behalf of another person (such as a family member), you represent that you have legal authority to bind that person to these Terms and have obtained their consent.
Claim Knight provides AI-powered analysis of Medicare claims data to help beneficiaries and their authorized representatives identify potential fraud, billing errors, and anomalies. The Service includes:
The Service does not guarantee the detection of all fraudulent or erroneous claims. The absence of alerts does not mean your claims are free of fraud or errors. We encourage you to regularly review your Medicare Summary Notices and Explanation of Benefits independently.
We are not affiliated with the U.S. government, the Centers for Medicare & Medicaid Services (CMS), or the federal Medicare program. The Service is independently operated by a licensed insurance agency.
To use Claim Knight, you must:
You are responsible for maintaining the confidentiality of your account credentials and for all activity that occurs under your account. You agree to notify us immediately of any unauthorized access to or use of your account. We are not liable for any loss or damage arising from unauthorized use of your account, except where such loss results from our failure to maintain adequate security measures.
We offer the following subscription tiers:
Paid subscriptions are billed monthly or annually in advance. Payments are processed by Stripe, Inc. By subscribing, you authorize us to charge your designated payment method on a recurring basis until you cancel. Annual plans are billed at a discounted rate equivalent to 10 months of the monthly price.
Automatic Renewal: Your subscription will automatically renew at the end of each billing period (monthly or annually) at the then-current price, unless you cancel before the renewal date. We will notify you before any price increases take effect.
You may cancel your subscription at any time through your account settings or by contacting us via email, phone, or through the Service. Cancellation is effective immediately — you do not need to call or navigate complicated steps. Upon cancellation, you will retain access to your paid features through the end of your current billing period. We do not offer prorated refunds for partial billing periods.
30-Day Satisfaction Guarantee: If you are dissatisfied with the Service for any reason within the first 30 days of your initial paid subscription, you may request a full refund by contacting us. This guarantee applies only to your first subscription period and is limited to one refund per person.
Licensed insurance agencies may access the Service through our Agency Partner Program under a separate Agency Partner Agreement. Agency Partners may offer the Service to their clients under a white-label arrangement. The terms governing Agency Partner access, pricing, branding, data handling, compliance obligations, and client data protections are set forth in the Agency Partner Agreement, which must be fully executed before any Agency Partner may access or resell the Service. The Agency Partner Agreement supplements these Terms.
No agency may offer, resell, or white-label the Service without a fully executed Agency Partner Agreement. Agencies interested in partnering with us should contact us at the information provided in Section 16 below.
By connecting your Medicare account through the Blue Button 2.0 API, you authorize us to access and analyze your Medicare claims data solely for the purposes described in our Privacy Policy & Notice of Privacy Practices. You may revoke this authorization at any time through Medicare.gov or by contacting us. Revocation will not affect any analysis already completed prior to revocation.
You agree not to:
All content, features, and functionality of the Service, including but not limited to software, algorithms, text, graphics, logos, and user interfaces, are owned by or licensed to the Company and are protected by copyright, trademark, and other intellectual property laws. Your subscription grants you a limited, non-exclusive, non-transferable license to use the Service for its intended purpose during your subscription period.
TO THE MAXIMUM EXTENT PERMITTED BY APPLICABLE LAW, THE COMPANY SHALL NOT BE LIABLE FOR ANY INDIRECT, INCIDENTAL, SPECIAL, CONSEQUENTIAL, OR PUNITIVE DAMAGES, INCLUDING BUT NOT LIMITED TO LOSS OF PROFITS, DATA, OR OTHER INTANGIBLE LOSSES, ARISING OUT OF OR RELATED TO YOUR USE OF OR INABILITY TO USE THE SERVICE.
OUR TOTAL AGGREGATE LIABILITY TO YOU FOR ALL CLAIMS ARISING OUT OF OR RELATED TO THE SERVICE SHALL NOT EXCEED THE GREATER OF (A) THE TOTAL AMOUNT YOU PAID TO US IN THE TWELVE (12) MONTHS PRECEDING THE CLAIM, OR (B) ONE HUNDRED DOLLARS ($100).
THE SERVICE IS PROVIDED "AS IS" AND "AS AVAILABLE" WITHOUT WARRANTIES OF ANY KIND, EITHER EXPRESS OR IMPLIED, INCLUDING BUT NOT LIMITED TO WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, AND NON-INFRINGEMENT.
Exceptions — This limitation does NOT apply to:
You agree to indemnify, defend, and hold harmless the Company, its officers, directors, employees, and agents from and against any claims, liabilities, damages, losses, and expenses (including reasonable attorneys' fees) arising out of or related to: (a) your use of the Service, (b) your violation of these Terms, (c) your infringement of any third-party rights, or (d) your provision of false or misleading information. This indemnification obligation shall survive termination of your account.
These Terms shall be governed by and construed in accordance with the laws of the State of South Carolina, without regard to its conflict of law provisions. This agreement involves interstate commerce, and the Federal Arbitration Act (FAA) shall govern the interpretation and enforcement of the arbitration provisions in this Section.
Any dispute, claim, or controversy arising out of or related to these Terms or the Service ("Dispute") shall be resolved through binding arbitration administered by the American Arbitration Association ("AAA") under its Consumer Arbitration Rules. Arbitration may be conducted in Greenville County, South Carolina, at another location mutually agreed upon by the parties, or virtually (by phone or video conference) at your election.
Notwithstanding Section 13.2, either party may bring a claim in small claims court if it qualifies. Either party may also seek injunctive or other equitable relief in any court of competent jurisdiction to prevent the actual or threatened infringement of intellectual property rights.
All disputes must be brought in the parties' individual capacity, and not as a plaintiff or class member in any class, collective, or representative proceeding. The arbitrator may not consolidate more than one person's claims.
You may opt out of the arbitration and class action waiver provisions by sending written notice to alex@happyhealthagency.net within 30 days of first accepting these Terms. Your notice must include your name, address, and a clear statement that you wish to opt out of the arbitration clause. If you opt out, all disputes will be resolved in the state or federal courts located in Greenville County, South Carolina.
We operate in compliance with all applicable federal and state laws, including HIPAA, the HITECH Act, South Carolina state laws regarding data protection and breach notification, and applicable consumer protection statutes including automatic renewal laws. If any provision of these Terms conflicts with applicable law, the applicable law shall prevail to the extent of the conflict.
We reserve the right to modify these Terms at any time. We will notify you of material changes by email at least 30 days before they take effect, and by posting the updated Terms on our website with a new effective date. Your continued use of the Service after the effective date of changes constitutes acceptance of the updated Terms. If you do not agree with the changes, you must stop using the Service and cancel your subscription before the effective date.
For questions about these Terms, please contact us:
Claim Knight
Happy Health Agency
Palmetto Health Pro, LLC
Email: alex@happyhealthagency.net
Phone: (864) 507-5373
Hours: Monday – Friday, 9:00 AM – 5:00 PM Eastern Time