Common use of Benefit Exclusion or Delay Clause in Contracts

Benefit Exclusion or Delay. In cases where third party or first party payor liability is being pursued, and upon the execution and delivery to Company of all documents required by it, to secure its rights of subrogation, reimbursement and right of recovery entitlements, as provided in this Section 5.16, the Company may pay benefits in connection with such Injury or Illness if it is satisfied that its subrogation, reimbursement and recovery rights are being upheld and shall be repaid only from the proceeds (beginning with the first proceeds) of any and all recoveries, if any, from or on behalf of such third party or from any first party payor. As security for such repayment, the Company shall have a lien, as provided in this Section 5.16, against any and all such recoveries to the extent of the amount advanced to the Covered Person by Company.

Appears in 10 contracts

Samples: Group Health Insurance Agreement, Health Insurance Agreement, Group Health Insurance Agreement

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