Approval for Implementation



Approval for Legal eXchange( Implementation

Approval is requested for this law firm to implement Legal eXchange( for use in legal e-bill submission, review, processing and payment with The Hartford Financial Services Group, Inc. and its Claims organization. The requesting law firm agrees:

➢ Upon approval, law firm will submit legal invoices electronically through Legal eXchange( on matters as directed by The Hartford.

➢ At the time of payment, approved legal fees will be discounted 1.2% to offset costs and expenses associated with use of the system.

➢ There will be no discount on the portion of any legal invoice that constitutes expense reimbursement.

Implementation on Legal eXchange( is subject to discretion and approval of The Hartford. The firm will receive confirmation of this application being approved from The Hartford and/or Bottomline Technologies.

Law Firm Name: _________________________________________________________________________

Law Firm Mailing Address: ______________________ Physical Address _________________________

___________________________________________ _______________________________________

___________________________________________ ________________________________________

Law Firm Approver Name – Print Law Firm Approver Title

Law Firm Approver Name –Signature Date

PLEASE identify a person from your firm that Bottomline Technologies may contact and who will have responsibility for managing the law firm’s implementation of the Legal eXchange( service:

Project Coordinator Name Project Coordinator Telephone

Project Coordinator Title Project Coordinator Email

Please fax or email this page to Legal Practices & Support:

Fax: (860) 547-8266

Email: Legal.ebilling@

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