REDUCTIONS – THIRD PARTY LIABILITY. If the Subscriber is injured or becomes ill due to the act or omission of another person (a “third party”), Blue Shield shall, with respect to Services required as a result of that injury, provide the ben- efits of this Agreement and have an equitable right to restitution, reimbursement or other available remedy to recover the amounts Blue Shield paid for Services provided to the Subscriber on a fee-for- service basis from any recovery (defined below) obtained by or on behalf of the Member, from or on behalf of the third party responsible for the in- jury or illness or from uninsured/underinsured mo- torist coverage. Blue Shield’s right to restitution, reimbursement or other available remedy is against any recovery the Member receives as a result of the injury or illness, including any amount awarded to or received by way of court judgment, arbitration award, settle- ment or any other judgment, from any third party or third party insurer, or from uninsured or under- insured motorist coverage, related to the illness or injury (the “Recovery”), without regard to whether the Member has been “made whole” by the Recov- ery. Blue Shield’s right to restitution, reimburse- ment or other available remedy is with respect to that portion of the total Recovery that is due Blue Shield for the Benefits it paid in connection with such injury or illness, calculated in accordance with California Civil Code section 3040. The Subscriber is required to:
1. Notify Blue Shield in writing of any actual or potential claim or legal action which such Sub- xxxxxxx expects to bring or has brought against the third party arising from the alleged acts or omissions causing the injury or illness, not later than 30 days after submitting or filing a claim or legal action against the third party; and,
2. Agree to fully cooperate with Blue Shield to execute any forms or documents needed to en- able Blue Shield to enforce its right to restitu- tion, reimbursement or other available remedies; and,
3. Agree in writing to reimburse Blue Shield for Benefits paid by Blue Shield from any Recov- ery when the Recovery is obtained from or on behalf of the third party or the insurer of the third party, or from uninsured or underinsured motorist coverage; and,
4. Provide Blue Shield with a lien in the amount of Benefits actually paid. The lien may be filed with the third party, the third party’s agent or attorney, or the court, unless otherwise prohib- ited by law; and,
5. Periodically respond to inform...
REDUCTIONS – THIRD PARTY LIABILITY. If a Member is injured or becomes ill due to the act or omission of another person (a “third party”), Blue Shield shall, with respect to services required as a result of that injury, provide the Benefits of the plan and have an equitable right to restitution, reimbursement or other available to recover the amounts Blue Shield paid for services provided to the Member on a fee-for-service basis from any recovery (defined below) obtained by or on behalf of the Member, from or on behalf of the third party responsible for the injury or illness or from uninsured/underinsured motorist coverage. Blue Shield’s right to restitution, reimbursement or other available remedy is against any recovery the Member receives as a result of the injury or illness, including any amount awarded to or received by way of court judgment, arbitration award, settlement or any other arrangement, from any third party or third party insurer, or from uninsured or underinsured motorist coverage, related to the illness or injury (the “Recovery”), without regard to whether the Member has been “made whole” by the Recovery. The amount Blue Shield seeks as restitution, reimbursement or other available remedy will be calculated in accordance with California Civil Code section 3040. The Member is required to:
REDUCTIONS – THIRD PARTY LIABILITY. If another person or entity, through an act or omis- sion, causes a Member to suffer an injury or illness, and if Blue Shield paid Benefits for that injury or ill- ness, the Member must agree to the provisions listed below. In addition, if the Member is injured and no other person is responsible but the Member receives (or is entitled to) a recovery from another source, and if Blue Shield paid Benefits for that injury, the Mem- ber must agree to the following provisions.
REDUCTIONS – THIRD PARTY LIABILITY. If a Member is injured or becomes ill due to the act or omis- sion of another person (a “third party”), Blue Shield or a con- tracted Dental Plan Administrator shall, with respect to ser- vices required as a result of that injury, provide the Benefits of the Plan and have an equitable right to restitution, xxxx- bursement or other available remedy to recover the amounts Blue Shield paid for services provided to the Member from any recovery (defined below) obtained by or on behalf of the Member, from or on behalf of the third party responsible for the injury or illness or from uninsured/underinsured motorist coverage. This right to restitution, reimbursement or other available remedy is against any recovery the Member receives as a re- xxxx of the injury or illness, including any amount awarded to or received by way of court judgment, arbitration award, set- tlement or any other arrangement, from any third party or third party insurer, or from uninsured or underinsured mo- torist coverage, related to the illness or injury (the “Recov- ery”), without regard to whether the Member has been “made whole” by the Recovery. The right to restitution, reimburse- ment or other available remedy is with respect to that portion of the total Recovery that is due for the Benefits paid in con- nection with such injury or illness, calculated in accordance with California Civil Code Section 3040. The Member is required to:
REDUCTIONS – THIRD PARTY LIABILITY. If a Member is injured or becomes ill due to the act or omission of another person (a “third party”), Blue Shield or a contracted Dental Plan Administrator shall, with respect to services required as a result of that injury, provide the Benefits of the Plan and have an equitable right to restitution, reimbursement or other available remedy to recover the amounts Blue Shield paid for services provided to the Member from any recovery (defined below) obtained by or on behalf of the Member, from or on behalf of the third party responsible for the injury or illness or from uninsured/underinsured motorist coverage. This right to restitution, reimbursement or other available remedy is against any recovery the Member receives as a result of the injury or illness, including any amount awarded to or received by way of court judgment, arbitration award, settlement or any other arrangement, from any third party or third party insurer, or from uninsured or underinsured motorist coverage, related to the illness or injury (the “Recovery”), without regard to whether the Member has been “made whole” by the Recovery. The right to restitution, reimbursement or other available remedy is with respect to that portion of the total Recovery that is due for the Benefits paid in connection with such injury or illness, calculated in accordance with California Civil Code Section 3040. The Member is required to:
REDUCTIONS – THIRD PARTY LIABILITY. If a Member is injured or becomes ill due to the act or omission of another person (a “third party”), Blue Shield or a contracted Dental Plan Adminis- trator shall, with respect to Services required as a result of that injury, provide the Benefits of the Plan and have an equitable right to restitution, re- imbursement or other available remedy to recover the amounts Blue Shield paid for Services provided to the Member from any recovery (defined below) obtained by or on behalf of the Member, from or on behalf of the third party responsible for the injury or illness or from uninsured/underinsured motorist coverage. This right to restitution, reimbursement or other available remedy is against any recovery the Mem- ber receives as a result of the injury or illness, in- cluding any amount awarded to or received by way of court judgment, arbitration award, settlement or any other arrangement, from any third party or third party insurer, or from uninsured or underinsured motorist coverage, related to the illness or injury (the “Recovery”), without regard to whether the Member has been “made whole” by the Recovery. The right to restitution, reimbursement or other available remedy is with respect to that portion of the total Recovery that is due for the Benefits paid in connection with such injury or illness, calculated in accordance with California Civil Code Section 3040. The Member is required to:
REDUCTIONS – THIRD PARTY LIABILITY. If a Member is injured or becomes ill due to the act or omission of another person (a “third party”), Blue Shield shall, with respect to services required as a result of that injury, provide the Benefits of the plan and have an equitable right to restitution, reimbursement or other available to recover the amounts Blue Shield paid for services provided to the Member on a fee-for-service basis from any recovery (defined below) obtained by or on behalf of the Member, from or on behalf of the third party responsible for the injury or illness or from uninsured/underinsured motorist coverage. Blue Shield’s right to restitution, reimbursement or other reimbursement or other available remedy will be calculated in accordance with California Civil Code section 3040. The Member is required to:
REDUCTIONS – THIRD PARTY LIABILITY. If the Subscriber is injured or becomes ill due to the act or omission of another person (a “third party”), Blue Shield shall, with respect to Services required as a result of that injury, provide the ben- efits of this Agreement and have an equitable right to restitution, reimbursement or other available remedy to recover the amounts Blue Shield paid for Services provided to the Subscriber on a fee-for- service basis from any recovery (defined below) obtained by or on behalf of the Member, from or on behalf of the third party responsible for the in- jury or illness or from uninsured/underinsured mo- torist coverage. Blue Shield’s right to restitution, reimbursement or other available remedy is against any recovery the Member receives as a result of the injury or illness, including any amount awarded to or received by way of court judgment, arbitration award, settle- ment or any other judgment, from any third party or third party insurer, or from uninsured or under- insured motorist coverage, related to the illness or injury (the “Recovery”), without regard to whether the Member has been “made whole” by the Recov-
REDUCTIONS – THIRD PARTY LIABILITY. If the Subscriber is injured or becomes ill due to the act or omission of another person (a “third party”), Blue Shield shall, with respect to Services required as a result of that injury, provide the benefits of this Agreement and have an equitable right to restitution, reimbursement or other available remedy to recover the amounts Blue Shield paid for Services provided to the Subscriber on a fee- for-service basis from any recovery (defined below) obtained by or on behalf of the Member, from or on behalf of the third party responsible for the injury or illness or from uninsured/underinsured motorist coverage. Blue Shield’s right to restitution, reimbursement or other available remedy is against any recovery the Member receives as a result of the injury or illness, including any amount awarded to or received by way of court judgment, arbitration award, settlement or any other judgment, from any third party or third party insurer, or from uninsured or underinsured motorist coverage, related to the illness or injury (the “Recovery”), without regard to whether the Member has been “made whole” by the Recovery. Blue Shield’s right to restitution, reimbursement or other available remedy is with respect to that portion of the total Recovery that is due Blue Shield for the Benefits it paid in connection with such injury or illness, calculated in accordance with California Civil Code section 3040. The Subscriber is required to:
1. Notify Blue Shield in writing of any actual or potential claim or legal action which such Subscriber expects to bring or has brought against the third party arising from the alleged acts or omissions causing the injury or illness, not later than 30 days after submitting or filing a claim or legal action against the third party; and,
