Common Contracts
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MID-AMERICA CARPENTERS REGIONAL COUNCIL HEALTH FUND REIMBURSEMENT AGREEMENT FOR THIRD-PARTY CAUSATIONApril 29th, 2024
This Reimbursement Agreement (“RA”) between the Undersigned and the Mid-America Carpenters Regional Council Health Fund (“Fund”) is entered into to compel the Fund to advance payment for medical treatment and/or disability benefits that are incurred as a result of the injury or illness sustained on the date-of- injury indicated below (“Injury”), which may have been caused, contributed to, or aggravated under circumstances that may permit the Undersigned to obtain compensation from a third party, or any other source of coverage (“Third Party”). The Fund provides no benefits for claims that are related to any injury or illness that is caused by third-parties or is the responsibility of any other entity or other source of coverage, but the Fund may advance benefits that may be related to the Injury in exchange for the Undersigned’s agreement to the terms contained herein. The rights of the Fund listed herein are not exhaustive, and the plan document (“Plan”) controls to the extent there a
