Subrogation and Right of Recovery. If HMO provides health care benefits under this Certificate to a Member for injuries or illness for which another party is or may be responsible, then HMO retains the right to repayment of the full cost of all benefits provided by HMO on behalf of the Member that are associated with the injury or illness for which another party is or may be responsible. HMO’s rights of recovery apply to any recoveries made by or on behalf of the Member from the following sources, including but not limited to: payments made by a third-party tortfeasor or any insurance company on behalf of the third-party tortfeasor; any payments or awards under an uninsured or underinsured motorist coverage policy; any Workers’ Compensation or disability award or settlement; medical payments coverage under any automobile policy, premises or homeowners medical payments coverage or premises or homeowners insurance coverage; any other payments from a source intended to compensate a Member for injuries resulting from an accident or alleged negligence. The Member specifically acknowledges HMO’s right of subrogation. When HMO provides health care benefits for injuries or illnesses for which another party is or may be responsible, HMO shall be subrogated to the Member’s rights of recovery against any party to the extent of the full cost of all benefits provided by HMO. HMO may proceed against any party with or without the Member’s consent. The Member also specifically acknowledges HMO’s right of reimbursement. This right of reimbursement attaches when HMO has provided health care benefits for injuries or illness for which another party is or may be responsible and the Member and/or the Member’s representative has recovered any amounts from another party or any party making payments on the party’s behalf. By providing any benefit under this Certificate, HMO is granted an assignment of the proceeds of any settlement, judgment or other payment received by the Member to the extent of the full cost of all benefits provided by HMO. HMO’s right of reimbursement is cumulative with and not exclusive of HMO’s subrogation right and HMO may choose to exercise either or both rights of recovery. The Member and the Member’s representatives further agree to:
Subrogation and Right of Recovery. For purposes of subrogation and right of recovery, the Company will have the sole right to make claims under the Subrogation and Right of Recovery Provision contained in the Plan. In its sole discretion, the Company may litigate, negotiate, settle, compromise, release or waive any such claim. The Client hereby assigns to the Company all of its rights to make, litigate, negotiate, settle, compromise, release or waive any such claim. Claims subject to this subrogation and right of recovery section include, but are not limited to, recovery of covered expenses incurred by a covered person as the result of injuries or illness caused by a third party, recovery of covered expenses incurred by a covered person due to a work-related injury or sickness, and recovery of covered expenses through class action lawsuits. Recoveries under this Section will be distributed as follows:
Subrogation and Right of Recovery. For purposes of subrogation and right of recovery, the Company will have the sole right to make claims under the Subrogation and Right of Recovery Provision contained in the Plan. In its sole discretion, the Company may litigate, negotiate, settle, compromise, release or waive any such claim. The Plan Sponsor hereby assigns to the Company all of its rights to make, litigate, negotiate, settle, compromise, release or waive any such claim. Claims subject to this subrogation and right of recovery section include, but are not limited to, recovery of medical expenses incurred by a Member as the result of injuries or illness caused by a third party, recovery of medical expenses incurred by a Member due to work-related injury or sickness, and recovery of medical expenses through class action lawsuits. The Plan Sponsor will notify the Company immediately of any work-related accident suffered by a Member for which recovery may be available under any Workers' Compensation law or similar law. The Plan Sponsor also agrees to advise the Company of any potential subrogation rights or other contractual rights of recovery known to the Plan Sponsor. Legal expenses will not be used when calculating the aggregate stop-loss benefits, if any, according to the Stop Loss Policy issued by the Company to the Plan Sponsor.
Subrogation and Right of Recovery. For purposes of subrogation and right of recovery, the Company will have the sole right to make claims under the Subrogation and Right of Recovery Provision contained in the Plan. In its sole discretion, the Company may litigate, negotiate, settle, compromise, release or waive any such claim. The Plan Sponsor hereby assigns to the Company all of its rights to make, litigate, negotiate, settle, compromise, release or waive any such claim. Claims subject to this subrogation and right of recovery section include, but are not limited to, recovery of medical expenses incurred by a covered person as the result of injuries or illness caused by a third party, recovery of medical expenses incurred by a covered person due to work-related injury or sickness, and recovery of medical expenses through class action lawsuits. Legal expenses will not be used when calculating the individual stop-loss benefits or the aggregate stop-loss benefits, if any, pursuant to the Stop Loss Policy or Stop-Loss Agreement issued by the Company to the Plan Sponsor.
Subrogation and Right of Recovery. The Subrogation and Right of Recovery Section contained in the Certificate does not apply to Virginia residents, unless they are Federal Government Employees. All other terms and conditions of the Certificate shall remain in full force and effect except as amended herein. HMO DC2 COC-AMEND-1 07-03 1 (Revised 08/29/03) AETNA HEALTH INC. (DISTRICT OF COLUMBIA) CERTIFICATE OF COVERAGE AMENDMENT Contract Holder Group Agreement Effective Date: January 1, 2013 The Covered Benefits section of the Certificate is hereby amended to include the following provision:
Subrogation and Right of Recovery
