Right Of Reimbursement And Subrogation

No benefits will be paid by the Fund with respect to an injury, sickness or condition for which a "third party" may be liable or legally responsible. For this purpose, "third party" means a person or organization other than the participant who suffers the loss. However, the Fund will provide benefits according to plan terms provided that the participant agrees, in writing:

• To give the Fund written notice whenever a claim against a third party is made for damages as a result of an injury, sickness or condition;
• To reimburse the Fund in accordance with this provision from the first dollar payable to the participant for any benefit paid by the Fund when a recovery is obtained from or on behalf of the third party. This right of reimbursement applies regardless of:
  
  
  • the label assigned to the recovery;
  • any purported allocation or itemization of such recovery to specific types of injuries; and
  • the form of recovery (e.g., court judgment, arbitration award, settlement or any other arrangement).
    
    If the recovery is for damages other than for medical or dental care expenses, such as pain and suffering, the participant will still be required to reimburse the benefits paid by the Fund first. The Fund's right of reimbursement will apply to the first dollar recovered from the third party, before attorneys' fees and even if the recovery is less than the amount needed to reimburse the participant fully. The Fund's right of reimbursement will apply to all amounts received from or on behalf of the third part y, whether directly or indirectly, including, without limitation, payments to an account or trust on the participant's behalf;
    
    
• To ensure that any amounts received from or on behalf of a third party are kept separate and are not commingled with any other funds; and
• To notify the Fund within 10 days after receiving any recovery from or on behalf of a third party.
• That the Fund will be treated as subrogated to the extent of benefits paid and any rights of recovery that the participant may have against a third party, and that, in the implementation of such subrogation right, the Fund may directly pursue recovery against such third party and can treat the participant (and such individual's attorney) as acting as the Fund's agent with respect to the prosecution of any claim and the recovery of any amount, and that the participant will execute such further documents as may be necessary to effectuate the Fund's subrogation right.

In addition, the participant must execute a lien in favor of the Fund for the amount to which the Fund is entitled. However, even if the participant does not give the Fund a lien, the participant is liable to the Fund for reimbursement under these provisions.

In order to obtain reimbursement, the Fund will take such actions as the Board of Trustees, in its discretion, feels would best serve the Fund. The Fund may seek to have any payment by a third party made payable to the Fund in lieu of, or in addition to, the participant or his/her assigns or representatives.

The Fund will offset future payments to or on behalf of the participant (or other covered members of the participant's family) to collect a reimbursement. Additionally, the Fund will refuse to provide the participant (or other covered members of the participant's family) any benefits under the Fund if the participant:

• Refuses to execute an agreement agreeing to reimburse the Fund;
• Fails to reimburse the Fund; or
• Fails to cooperate in helping the Fund collect reimbursement from the participant or a third party.