|
Your Benefit Trust was created to provide you and your
dependents with medical care and to relieve you of the burden
of paying for it. However, cost for providing hospitalization
and medical 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:
Download Subrogation Agreement Form
Download Subrogation Accident Form
|
|
