Should I choose to have my personal assistant drive or transport me anywhere, I understand that it is my or my designated representative’s sole responsibility, as the employer of the personal assistant, to train and instruct my personal assistant on how he or she should transport me and drive his or my vehicle. I understand and acknowledge that it is my or my designated representative’s sole responsibility to gather and review the driving record and driving ability of my personal assistant.
I affirm and acknowledge that my personal assistant(s) is not an employee of Wellcare Health ManagementHome Care (“Fiscal Intermediary”) and, therefore, the Fiscal Intermediary has not reviewed my personal assistant’s driving record or driving abilities, and the Fiscal Intermediary has not provided any training to my personal assistant on driving, transporting consumers, or any similar tasks that are related to or involved in transporting a consumer from one location to another or in a vehicle.
I understand that I may ask my personal assistant to transport me in his/her vehicle or in my vehicle.
I understand that there is an inherent risk and danger of injury, including death, when being driven by another individual or being a passenger in a vehicle. I, and on behalf of any of my successors, assigns, heirs, executors, and administrators, do hereby waive, release, and forever discharge the Fiscal Intermediary and any of its related companies, affiliates, officers, agents, employees, representatives, executors, assigns, and all others associated with the Fiscal Intermediary or acting on its behalf, from any and all responsibilities or liability for injuries or damages that may result from having my personal assistant drive me to and from any location.
I, and on behalf of any of my successors, assigns, heirs, executors, and administrators, do also hereby release the Fiscal Intermediary and any of its related companies, affiliates, officers, agents, employees, representatives, and assigns from any responsibility or liability for any injury or damage to myself or others who may make a derivative claim for injury or damage to me, including those injuries or damages caused by the negligent act or omission of the Fiscal Intermediary or in any way arising out of or connected with my being driven by my personal assistant. My release of liability and waiver of claims expressly releases the Fiscal Intermediary from its own negligence which may result in any injury or damage to me or others, regardless of how such injury or damage may arise, and regardless of who is at fault.
To the fullest extent permitted by law, on behalf of myself, my personal representatives, and my heirs, administrators, executors, successors, and assigns, I hereby agree to fully release, waive, discharge, defend, indemnify, and hold harmless the Fiscal Intermediary and any of its affiliates or related companies, its officers, partners, representatives, agents, and employees from any and all claims, actions, damages, causes of action, or losses for bodily injury, illness, wrongful death, loss of services, other damages, or otherwise which may arise out of the fact that I was driven and transported by my personal assistant, whether in law or in equity, known or unknown, presently due or contingent, liquidated or unliquidated.
The Fiscal Intermediary and any of its related entities or affiliates, officers, partners, representatives, agents, and employees are not responsible for any loss or theft of personal property that may be caused by my personal assistant, whether such loss was caused by the personal assistant indirectly (i.e., through the personal assistant’s negligent care of my belongings) or directly (i.e., through the personal assistant’s theft of my belongings), and I release the Fiscal Intermediary and any of its related entities or affiliates, its officers, partners, representatives, agents, and employees from any liability for such loss or theft.