Subrogation and Reimbursement. 1. In the event a Participant is legally entitled to recover all or a portion of the cost of a service or a prescription drug covered by this Plan from a third party, the Employer will, upon making payment under this Plan, succeed to any rights of recovery the Participant may have or acquire (with respect to such service or prescription drug) against any individual or organization except insurers of individual hospital, surgical or medical policies issued to the Participant.
Subrogation and Reimbursement. Subject to the limitations of Section 10.2(d), the Committee shall maintain, as part of each Plan, a comprehensive subrogation and reimbursement policy, updated from time to time as appropriate.
Subrogation and Reimbursement. Subrogation is the substitution of one person or entity in the place of another with reference to a lawful claim, demand or right. We shall be subrogated to and shall succeed to all rights of recovery, under any legal theory of any type, for any actual payments made by us for services and benefits provided by us to any Covered Person as a result of the occurrence that gave rise to a cause of action in which the Covered Person has recovered for medical expenses from: (i) third parties, including any person alleged to have caused the Covered Person to suffer injuries or damages; (ii) the employer of the Covered Person or (iii) any person or entity obligated to provide benefits or payments to Covered Persons, including benefits or payments for underinsured or uninsured motorist protection (these third parties and persons or entities are collectively referred to as "Third Parties"); provided, however, that we will not seek to recover payments made to a Covered Person under a personal injury protection policy. The Covered Person agrees to assign to us all rights of recovery against Third Parties, to the extent of the actual payments made us for the services and benefits that we provided. The Covered Person shall cooperate with us in protecting our legal rights to subrogation and reimbursement. The Covered Person shall do nothing to prejudice our rights under this provision, either before or after the need for services or benefits under the Policy. We may, at our option, take necessary and appropriate action to preserve our rights under these subrogation provisions, including filing suit in the name of the Covered Person. For the actual payments made by us for services provided under the Policy, we may collect, at our option, amounts from the proceeds of any settlement (whether before or after any determination of liability) or judgment that may be recovered by the Covered Person or his or her legal representative, regardless of whether or not the Covered Person has been fully compensated. Any proceeds of settlement or judgment shall be held in trust by the Covered Person for our benefit under these subrogation provisions. Proceeds received by us will be reduced by a pro rata share of the court costs and legal fees incurred by the Covered Person applicable to the portion of the settlement returned to us. The Covered Person agrees to execute and deliver such documents (including a written confirmation of assignment, and consents to release medical records), and p...
Subrogation and Reimbursement. If the Plan is self-insured, the following provisions regarding subrogation and third-party reimbursement will apply.
Subrogation and Reimbursement. THIRD-PARTY LIABILITY
Subrogation and Reimbursement. These paragraphs apply when another party (including any insurer) is, or may be found to be, responsible for Your injury, illness or other condition and We have provided benefits related to that injury, illness or condition. As permitted by applicable state law, unless preempted by federal law, We may be subrogated to all rights of recovery against any such party (including Your own insurance carrier) for the benefits We have provided to you under this Policy. Subrogation means that We have the right, independently of you, to proceed directly against the other party to recover the benefits that We have provided. Subject to applicable state law, unless preempted by federal law, We may have a right of reimbursement if you or anyone on your behalf receives payment from any responsible party (including Your own insurance carrier) from any settlement, verdict or insurance proceeds, in connection with an injury, illness, or condition for which We provided benefits. Under Section 5-335 of the New York General Obligations Law, Our right of recovery does not apply when a settlement is reached between a plaintiff and defendant, unless a statutory right of reimbursement exists. The law also provides that, when entering into a settlement, it is presumed that You did not take any action against Our rights or violate any policy between You and us. The law presumes that the settlement between You and the responsible party does not include compensation for the cost of dental care services for which We provided benefits. We request that You notify Us within 30 days of the date when any notice is given to any party, including an insurance company or attorney, of Your intention to pursue or investigate a claim to recover damages or obtain compensation due to injury, illness or condition sustained by You for which we have provided benefits. You must provide all information requested by Us or Our representatives including, but not limited to, completing and submitting any applications or other forms or statements as We may reasonably request.
Subrogation and Reimbursement. Subrogation is the substitution of one person or entity in the place of another with reference to a lawful claim, demand or right. The Company shall be entitled to all rights of recovery for the reasonable value of services and Benefits provided by The Company to any Covered Person, from any third party or entity that either provides or is obligated to provide Benefits or payments to the Covered Person. The Covered Person agrees to execute and deliver such documents (including a written confirmation of assignment, and consents to release medical records), and provide such help as may be reasonably requested by The Company.
Subrogation and Reimbursement. When a Covered Person's Injury or Sickness appears to be someone else's fault, benefits otherwise payable under this plan for loss of time as a result of that Injury or Sickness will not be paid unless the Covered Person or his legal representative agree(s):
Subrogation and Reimbursement. (a) If the Plan pays benefits to any covered person or assignee for any injury, illness, expense or loss caused by a third party, the Plan will be subrogated for the full amount of such payments to all rights the covered person and/or assignee against any person, firm corporation or other entity in connection with any claim related to the injury, illness, expense or loss. All recoveries from a third party (whether by lawsuit, settlement or otherwise) must be used to reimburse the Plan for benefits paid. The Plan’s recovery will not be reduced for any reason unless the Board of Trustees agrees in writing to a reduction.
Subrogation and Reimbursement. (a) So long as no DCL Event of Default has occurred and is continuing, no FSA Party or its Affiliates shall exercise any FSA Rights or other rights with respect to pursuing a claim for subrogation or reimbursement of any Policy Claim with respect to an FSA MTN Business Policy, without the consent of DCL, not to be unreasonably withheld or delayed. Following such consent, such FSA Party will use commercially reasonable efforts to pursue subrogation and reimbursement rights on behalf of DCL and, to the extent applicable, such FSA Party and Reinsurers.
