Common use of Subrogation and Right of Recovery Clause in Contracts

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: (1) first, 35.4% of the gross recovery to the Company, and/or its designated vendor for services related to obtaining the recovery; and (2) secondly, to the Company to be applied to reduce the Company’s payment of Individual Stop-Loss Benefits under the Stop Loss Policy or Stop-Loss Contract, if any, issued by the Company to the Client for the Member in respect of whom the recovery was obtained; and (3) thirdly, to the Company to be applied to reduce the Company’s payment of Aggregate Stop-loss Benefits under the Stop Loss Policy or Stop-Loss Contract, if any, issued by the Company to the Client; and (4) fourthly, the remainder, if any, to be credited as returned claim money for the Contract Year in which such claim payment was made under the Plan. 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 Contract issued by the Company to the Client.

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: (1) first, 35.4% of the gross recovery to the Company, and/or its designated vendor for services related to obtaining the recovery; and (2) secondly, to the Company to be applied to reduce the Company’s payment of Individual Stop-Loss Benefits under the Stop Loss Policy or Stop-Loss ContractPolicy, if any, issued by the Company to the Client for the Member in respect of whom the recovery was obtained; and (3) thirdly, to the Company to be applied to reduce the Company’s payment of Aggregate Stop-loss Stop Loss Benefits under the Stop Loss Policy or Stop-Loss ContractPolicy, if any, issued by the Company to the Client; and (4) fourthly, the remainder, if any, to be credited as returned claim money for the Contract Year in which such claim payment was made under the PlanClient. Legal expenses will not be used when calculating the individual stop-stop loss benefits, or the aggregate stop- stop loss benefits, if any, pursuant to the Stop Loss Policy or Stop-Loss Contract issued by the Company to the Client.