Subrogation is the substitution of one person or entity in the place of another with reference to a lawful claim, demand or right. Immediately upon paying or providing any benefit, the Short Term Disability Plan and Salary Continuation Plan (STD Plans) shall be fully subrogated to and shall succeed to all rights of recovery and causes of action, under any legal theory of any type for the reasonable value of any services and benefits the Plans provided to you, from any or all of the following listed below.
In addition to any subrogation rights and in consideration of the coverage provided by the STD Plans and described in this Summary Plan Description, the STD Plans shall also have an independent right to be reimbursed by you for the reasonable value of any service and benefits the STD Plans provide to you, from any or all of the following listed below:
third parties, including any person or tortfeasor alleged to have caused you to suffer injuries or damages;
any person or entity who is or may be obligated to provide benefits or payments to you, including benefits or payments for underinsured or uninsured motorist protection, no-fault or traditional auto LQVXUDQFHPHGLFDOSD\PHQWFRYHUDJHDXWRKRPHRZQHUVRURWKHUZLVHZRUNHUV¶FRPSHQVDWLRQ coverage, and/or any other insurance program or from other insurance carriers or third party administrators; and
any person or entity that is liable for payment to you on any equitable or legal liability theory. These responsible or potentially responsible, third parties and persons or entities are collectively referred WRDV7KLUG3DUWLHV´
By participating in the STD Plans, you agree as follows:
tKDWE\DFFHSWLQJSODQEHQHILWV\RXFRQVHQWWRWKHSODQV¶ULJKWWRVXEURJDWLRQRUUHLPEXUVHPHQW and consent to hold any payment, amount or recovery received from a third Party in constructive trust, lien and/or equitable lien by agreement in favor of the STD Plans;
tKDW\RXZLOOFRRSHUDWHZLWKWKH67'3ODQVLQDWLPHO\PDQQHULQSURWHFWLQJWKH67'3ODQV¶OHJDO and equitable rights to subrogation and reimbursement, including, but not limited to:
signing and/or delivering such documents as the Plan or its agents reasonably request to secure the subrogation and reimbursement claim;
responding to requests for information about any accident or injuries; appearing at depositions and in court;
obtaining the consent of the STD Plans or its agents before releasing any party from liability or payment of medical expenses, and
taking no action that might impair, prejudice or discharge your right to recovery or the STD PODQV¶ULJKWWRVXEURJDWLRQRUUHLPEXUVHPHQW;
that failure to cooperate in this manner shall be deemed a breach of contract and may result in the termination of plan benefits and/or the institution of legal action against you;
that the STD Plans have the sole authority and discretion to resolve all disputes regarding the interpretation of the language stated herein;
tKDWQRFRXUWFRVWVRUDWWRUQH\V¶IHHVPD\EHGHGXFWHGIURPWKH67'3ODQV¶UHFRYHU\ZLWKRXWWKH 67'3ODQV¶H[SUHVVZULWWHQFRQVHQWDQ\VR-calleG³)XQG'RFWULQH´RU³&RPPRQ)XQG'RFWULQH´ RU´$WWRUQH\¶V)XQG'RFWULQH´VKDOOQRWGHIHDWWKLVULJKWDQGWKH67'3ODQV¶DUHQRWUHTXLUHGWR SDUWLFLSDWHLQRUSD\FRXUWFRVWVRUDWWRUQH\V¶IHHVWRWKHDWWRUQH\KLUHGE\\RXWRSXUVXHD damage/personal injury claim;
that, regardless of whether you have been fully compensated or made whole, the STD Plans may collect from you the reasonable value of any services and benefits provided by the STD Plans, as well as collection costs, from the proceeds of any full or partial recovery that you or your legal representative obtains, whether before or after any determination of liability. The proceeds available for collection shall not be limited to only that recovery that is designated for medical costs and expenses, and shall include, but not be limited to any and all amounts earmarked as non-HFRQRPLFGDPDJHVVHWWOHPHQWRUMXGJPHQW7KH67'3ODQV¶ULJKWWRUHFRYHUWKHSURFHHGV is not affected by the timing of the recovery (whether before or after any determination of liability), RUWKHPDQQHULQZKLFKWKHUHFRYHU\LVVWUXFWXUHGRUZRUGHG7KH67'3ODQV¶DELOLW\WRFROOHFW shall not be affected or reduced by the so-FDOOHG³0DNH:KROH'RFWULQH´³)XQG'RFWULQH´ ³&RPPRQ)XQGGRFWULQH´³&ROODWHUDO6RXUFHUXOH´RUDQ\other equitable defenses that may DIIHFWWKH67'3ODQV¶ULJKWWRVXEURJDWLRQRUUHLPEXUVHPHQW;
that benefits paid by the STD Plans may also be considered to be benefits advanced;
tKDW\RXDJUHHWKDWRQFH67'3ODQV¶EHQHILWVDUHSDLGDFRQVWUXFWLYHWUXVW lien or equitable lien by agreement in favor of the plan exists with regard to any recovery, including by settlement (either before or after any determination of liability) or judgment, from a Third Party. As such, if you or your agent, including his attorney, receives any payment from any Third Party as a result of any injury or illness, whether by settlement (either before or after any determination of liability), or judgment, you or your agent will serve as a constructive trustee and fiduciary over the funds, which will be held on behalf of the STD Plans and failure to hold such funds in trust will be deemed as a breach of your duties hereunder. Such breach may result in the termination of plan benefits or the institution of legal action against you or your agent;
that you or an authorized agent, such as the your attorney, must hold any funds received from any Third Party that are due and owed to the STD Plans, as stated herein, separately and alone, and failure to hold funds as such will be deemed a breach of contract and may result in the termination of plan benefits or the institution of legal action against you or your authorized agent; that the STD Plans shall be entitled to recover reasonable attorney fees from you in collecting
from you any funds held by you that were recovered from any Third Party;
that the STD Plans may set off from any future benefits otherwise allowed by the STD Plans the value of benefits paid or advanced under this section to the extent not recovered by the STD Plans;
that you will neither accept any settlement that does not fully compensate or reimburse the STD 3ODQVZLWKRXWWKH67'3ODQV¶ZULWWHQDSSURYDOQRUZLOO\RXGRDQ\WKLQJWRSUHMXGLFHWKH67' 3ODQV¶ULJKWVXQGHUWKLVVHFWLRQ;
SHORT-TERM DISABILITY
that you will assign to the STD Plans all rights of recovery against Third Parties, to the extent of the reasonable value of services and benefits the STD Plans provided, plus reasonable costs of collection;
tKDWWKH67'3ODQV¶ULJKWVZLOOEHFRQVLGHUHGDVDVSHFLILFDQGILUVWSULRULW\FODLPDJDinst Third Parties, including tortfeasors for whom you are seeking recovery, to be paid before any other of your claims are paid;
tKDWWKH67'3ODQV¶ULJKWVZLOOQRWEHUHGXFHGGXHWR\RXURZQQHJOLJHQFH;
that the STD Plans may, at its option, take necessary and appropriate action to preserve its rights under these subrogation provisions, including filing suit in your name, which does not obligate the STD Plans in any way to pay you part of any recovery the STD Plans might obtain;
that the STD Plans shall not be obligated in any way to pursue this right independently or on your behalf;
that you will not assign your rights to settlement or recovery against a Third Party to any other SDUW\LQFOXGLQJWKHLUDWWRUQH\VZLWKRXWWKH67'3ODQV¶H[SUHVVZULWWHQFRQVent; and
that if the injury or condition, giving rise to subrogation or reimbursement involves the wrongful GHDWKRID67'3ODQV¶EHQHILFLDU\WKLVVHFWLRQDSSOLHVWRWKHSHUVRQDOUHSUHVHQWDWLYHRIWKH GHFHDVHG67'3ODQV¶EHQHILFLDU\