As a condition to receiving medical benefits under the Plan, participants agree to transfer to the Plan their rights to recover damages in full for such benefits when an injury or illness occurs through the act or omission of another person. The participant agrees to execute or cause to be executed any and all documents required by the Plan, including a Subrogation Reimbursement Agreement and Accident Questionnaire, within thirty (30) days of receipt of the same, and to execute or cause to be executed any documents on behalf of minor dependents covered by the Plan. In the event the dependent is a minor, Chancery Court approval of such Subrogation Reimbursement Agreement may be required.
Alternatively, if a participant receives any recovery, by way of judgment, settlement or otherwise, from another person or business entity, the participant agrees to reimburse the Plan in full, in first priority, for any medical expenses paid by it (i.e., the Plan shall be first reimbursed fully to the extent of any and all benefits paid by it from any monies received, with the balance, if any, retained by the participant).
The obligation to reimburse the Plan, in full, in first priority, exists regardless of whether the settlement or judgment specifically designates the recovery, or a portion thereof, as including medical expenses.
The Plan's right of full recovery, either by way of subrogation or right of reimbursement, may be from funds the participant or legal representative of the participant receives or is entitled to receive from any third party or the insured's own uninsured/underinsured or medical payment motorist insurance.
The Plan may enforce reimbursement or subrogation rights by requiring the participant or legal representative of the participant to assert a claim to any of the foregoing coverage to which he may be entitled.
The Plan will not contribute to any attorney fees or costs associated with the participant's recovery efforts.
In the event any hospital, medical, and related service or benefit is provided for, or any payment is made or credit is extended to a participant for injuries or illnesses resulting from an act or omission of another party, the Plan will be subrogated and will succeed to the right of the participant to recovery against any person, organization or other carrier. The acceptance of such benefits hereunder will constitute such subrogation. The participant must remit to the Department of Finance and Administration, for the Plan, all sums recovered by suit, settlement or otherwise, on account of such hospital, medical, and related service or benefit, and must take such action, furnish such information and assistance, and execute such assignments and other instruments as may be required to facilitate enforcement of rights hereunder, and must take no action prejudicing the rights and interests of the Department of Finance and Administration hereunder.
Failure by the participant to execute such evidence of subrogation as may be required will make the participant liable for all costs and expenses incurred under the Plan in his behalf because of such hospital, medical and related services. Nothing contained in this provision will be deemed to change, modify, or vary the terms of the Coordination of Benefits section of this Plan Document.