International Association of Bridge, Structural, Ornamental and Reinforcing Iron Workers  Ironworkers Council of Southern Ohio -  Plan Administrators
   
 
 
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Subrogation Forms

Your Benefit Trust was created to provide you and your dependents with health care and to relieve you of the burden of paying for it. However, cost for providing hospitalization and heatlh care has risen so drastically that your Board of Trustees has adopted a policy requiring reimbursement to the Benefit Trust for any claims paid on your behalf if a third party is found to be liable and makes or will make payment and/ or settlement on those claims: The Benefit Trust is not interested in depriving you of any rights you may have against such third party and is prepared to cooperate with you and any attorney you may wish to retain in enforcing your claim: YOU ARE NOT REQUIRED TO FILE A CLAIM AGAINST THE THIRD PARTY, however, it is necessary to carry out the rules of your plan of benefits:

All accidents/injuries sustained outside of your home or personal property must have this subrogation agreement signed by the member and filed with the Trust Office prior to claims processing: Upon receipt of the executed agreement and accident information, we will process your claims based on Plan guidelines: If it should develop that you have no claim against or that the claim cannot be enforced against the third party, for any reason, no effort will be made to seek reimbursement from you:

Forms are being redesigned to meet current requirements

Download Subrogation Claim Form (This form is currently being modified)

 

 

 

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