BenefitGuard

Terms of Service

Last updated: February 11, 2026

Welcome to BenefitGuard. These Terms of Service (“Terms”) govern your access to and use of the BenefitGuard website, application, and services (collectively, the “Service”) operated by BenefitGuard (“we,” “us,” or “our”). By accessing or using the Service, you agree to be bound by these Terms. If you do not agree, do not use the Service.

1. Description of Service

BenefitGuard is an AI-powered informational tool designed to help you understand your health insurance benefits, find healthcare providers, analyze insurance documents, and learn about your rights under federal and state law. The Service uses artificial intelligence (including OpenAI's GPT-4o) to generate responses based on your questions, uploaded documents, and our curated knowledge base of healthcare regulations.

BenefitGuard is NOT a medical provider, law firm, insurance company, financial advisor, or licensed professional of any kind. The Service provides general informational guidance only. See our Disclaimers page for full details.

2. Eligibility

To use BenefitGuard, you must:

  • Be at least 18 years of age
  • Be a resident of the United States
  • Have the legal capacity to enter into a binding agreement
  • Provide accurate and complete information when creating an account

If you are using the Service on behalf of a family member or dependent, you represent that you have the legal authority to act on their behalf and agree to these Terms for them.

3. Account Registration and Security

To access most features of BenefitGuard, you must create an account. You are responsible for:

  • Maintaining the confidentiality of your login credentials
  • All activity that occurs under your account
  • Notifying us immediately of any unauthorized access at support@benefitguard.app

We reserve the right to suspend or terminate accounts that violate these Terms or that we reasonably believe are being used fraudulently.

4. Acceptable Use

You agree NOT to use the Service to:

  • Submit false, misleading, or fraudulent information
  • Attempt to obtain medical diagnoses, treatment recommendations, or prescriptions
  • Harass, abuse, or harm others through the platform
  • Upload malicious files, viruses, or harmful content
  • Reverse-engineer, scrape, or attempt to extract the underlying AI models or proprietary data
  • Use automated tools (bots, scrapers) to access the Service without written permission
  • Resell, redistribute, or commercially exploit the Service or its outputs
  • Violate any applicable local, state, national, or international law

5. Document Uploads

BenefitGuard allows you to upload insurance documents (such as Summary of Benefits and Coverage, Explanation of Benefits, medical bills, and denial letters) for AI-assisted analysis. By uploading documents, you represent that:

  • You have the legal right to share the documents with our Service
  • The documents may contain personal health information, and you consent to our processing of this information as described in our Privacy Policy
  • You understand that AI-generated analysis of documents may contain errors and should be verified with your insurance company

6. AI-Generated Content

Responses provided by BenefitGuard are generated by artificial intelligence and are intended for informational purposes only. You acknowledge and agree that:

  • AI responses may be inaccurate, incomplete, or outdated — insurance plans, laws, and regulations change frequently
  • You should always verify information directly with your insurance company, healthcare provider, or a qualified professional before making decisions
  • BenefitGuard does not guarantee the accuracy, completeness, or timeliness of any AI-generated content
  • Reliance on AI-generated information is at your own risk

7. Provider Directory Information

Our provider search feature uses data from Google Places, the National Plan and Provider Enumeration System (NPPES), and CMS Transparency in Coverage files. This information:

  • May not be current — provider networks, hours, and locations change
  • Does not constitute a guarantee that a provider is in your insurance network — always verify with your insurer before scheduling an appointment
  • Is provided as a convenience and should not be your sole source of provider information

8. Intellectual Property

The Service, including its design, code, AI models, curated knowledge base, and content, is owned by BenefitGuard and protected by copyright, trademark, and other intellectual property laws. You may not copy, modify, distribute, or create derivative works from any part of the Service without our prior written consent.

You retain ownership of any documents you upload. By uploading documents, you grant us a limited, non-exclusive license to process them for the purpose of providing the Service to you.

9. Disclaimers and Limitation of Liability

THE SERVICE IS PROVIDED “AS IS” AND “AS AVAILABLE” WITHOUT WARRANTIES OF ANY KIND, WHETHER EXPRESS OR IMPLIED, INCLUDING BUT NOT LIMITED TO IMPLIED WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, AND NON-INFRINGEMENT.

TO THE MAXIMUM EXTENT PERMITTED BY LAW, BENEFITGUARD SHALL NOT BE LIABLE FOR ANY INDIRECT, INCIDENTAL, SPECIAL, CONSEQUENTIAL, OR PUNITIVE DAMAGES, OR ANY LOSS OF PROFITS OR REVENUES, WHETHER INCURRED DIRECTLY OR INDIRECTLY, OR ANY LOSS OF DATA, USE, GOODWILL, OR OTHER INTANGIBLE LOSSES, RESULTING FROM:

  • Your use of or inability to use the Service
  • Any errors, inaccuracies, or omissions in AI-generated content
  • Any decisions you make based on information provided by the Service, including but not limited to medical, legal, financial, or insurance-related decisions
  • Unauthorized access to or alteration of your data
  • Any third-party content or services accessed through the platform

IN NO EVENT SHALL OUR TOTAL LIABILITY EXCEED THE AMOUNT YOU PAID TO US IN THE TWELVE (12) MONTHS PRECEDING THE CLAIM, OR $100, WHICHEVER IS GREATER.

10. Indemnification

You agree to indemnify, defend, and hold harmless BenefitGuard, its officers, directors, employees, and agents from any claims, damages, losses, liabilities, and expenses (including reasonable attorneys' fees) arising from your use of the Service, violation of these Terms, or infringement of any third-party rights.

11. Termination

You may stop using the Service and delete your account at any time through your account settings. We may suspend or terminate your access if you violate these Terms, if required by law, or if we discontinue the Service.

Upon termination, your right to use the Service ceases immediately. We will delete your account data in accordance with our Privacy Policy, except as required to comply with legal obligations.

12. Changes to These Terms

We may update these Terms from time to time. When we make material changes, we will notify you by email or by posting a notice on the Service prior to the changes taking effect. Your continued use of the Service after the effective date constitutes acceptance of the updated Terms.

13. Governing Law and Dispute Resolution

These Terms are governed by the laws of the State of New York, without regard to its conflict of law provisions. Any disputes arising from these Terms or the Service shall be resolved through binding arbitration administered by the American Arbitration Association, except that either party may seek injunctive relief in a court of competent jurisdiction. The arbitration shall take place in New York, New York.

14. Severability

If any provision of these Terms is found to be unenforceable, the remaining provisions will continue in full force and effect.

15. Entire Agreement

These Terms, together with our Privacy Policy and Disclaimers, constitute the entire agreement between you and BenefitGuard regarding the use of the Service.

16. Contact Us

If you have questions about these Terms, please contact us at: