THIRD PARTY LIABILITY: If a Covered Person has medical charges:

  1. as a result of the negligence or intentional acts of a third party; and
  2. the Covered Person makes a claim for benefits under the Plan for such charges which exceed $500;
prior to any further payment, the Covered Person (or legal representative of a minor or incompetent) must agree in writing (a notorized Reimbursement Agreement) to repay the Company from any amount of money received by the Covered Person from the third party (or its insurer).

This Plan is entitled to recover from any and all settlements or judgments, even those designated as "pain and suffering" or "non-economic damages" only. The Plan has first priority to receive reimbursement from any recovery whether or not the injured party is made whole. The repayment will be to the extent of the benefits paid by the Plan, but will not exceed the amount of the payment received by the Covered Person from the third party (or its insurer). The Third Party Administrator is entitled to receive reimbursement whether or not you are still covered under this Plan at the time you receive any funds. We will not be responsible for any additional expenses, such as attorney fees or court costs, which you may incur in your efforts to seek reimbursement from any other party.

The repayment agreement will be binding upon the Covered Person (or legal representative of a minor or incompetent) whether or not:

  1. the payment received from the third party (or its insurer) is the result of:
    2. (a) a legal judgment;
    (b) an arbitration award;
    (c) a compromise settlement;
    (d) any other arrangement.
  2. the third party (or its insurer) has admitted liability; or
  3. the medical charges are itemized in the third party payment.

(In the case of conflicting information, your Schedule of Benefits takes precedence.)

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