Reso 2010-1529 - Laserfiche WebLink

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') to compensate a Member for injuries resulting from an accident or alleged negligence. For purposes of this Contract, a tortfeasor is any party who has committed injury, or wrongful act done willingly, negligently or in circumstances involving strict liability, but not including breach of contract for which a civil suit can be brought. 14.01 Member specifically acknowledges AvMed's right of subrogation. When AvMed provides health care benefits for injuries or illnesses for which a third party is or rnay be responsible, AvMed shall be subrogated to the Member's rights of recovery against any party to the extent of the full cost of all benefits provided by AvMed, to the fullest extent permitted by law. AvMed may proceed against any party with or without the Member's consent. 14.02 Mernber also specifically acknowledges AvMed's right ofreirnbursement. This right of reimbursement attaches, to the fullest extent permitted by law, when AvMed has provided health care benefits for injuries or illness for which another party is or may be responsible and the Member and/or the Member's representative has recovered any amounts from the third party or any party rnaking payments on the third party's behalf. By providing any benefit under this Contract, AvMed is granted an assignment of the proceeds of any settlement, judgrnent or other payment received by the Member to the extent of the full cost of all benefits provided by AvMed. AvMed's right of reimbursement is cumulative with and not exclusive of AvMed's suhrogation right and AvMed may choose to exercise either or both rights of recovery. 14.03 Member and the Member's representatives further agree to: 14.03.01 NotifY AvMed promptly and in writing when notice is given to any third party of the intention to investigate or pursue a claim to recover damages or obtain compensation due to injuries or illness sustained by the Member that may be the legal responsibility of a third party; and 14.03.02 Cooperate with AvMed and do whatever is necessary to secure AvMed's rights of subrogation and/or reimbursement under this Contract; and 14.03.03 Give AvMed a first-priority lien on any recovery, settlement or judgment or other source of compensation which may be had from a third party to the extent of the full cost of all benefits associated with injuries or illness provided by AvMed for which a third party is or rnay be responsible (regardless of whether specifically set forth in the recovery, settlement, judgment or cornpensation agreernent); and 14.03.04 Pay, as the first priority, from any recovery, settlernent or judgment or other source of cornpensation, any and all amounts due AvMed as reimbursement for the full cost of all benefits associated with injuries or illness provided by AvMed for which a third party is or may be responsible (regardless of whether specifically set forth in the recovery, settlernent, judgment, or compensation agreement), unless otherwise agreed to by AvMed in writing; and 14.03.05 Do nothing to prejudice AvMed's rights as set forth above. This includes, but is not limited to, refraining from rnaking any settlement or recovery, which specifically attempts to reduce or exclude the full cost of all benefits, provided by AvMed. 14.04 AvMed rnay recover the full cost of all benefits provided by AvMed under this Contract without regard to any claim of fault on the part of the Mernber, whether by comparative negligence or otherwise. No court costs or attorney fees may be deducted from AvMed's recovery without the prior express written consent of AvMed. In the event the Member or the Mernber's representative fails to cooperate with AvMed, the Member shall be responsible for all benefits paid by AvMed in addition to costs and attorney's fees incurred by AvMed in obtaining repayment. ) :) 37 A V-GI00-2009 MP-5319 (10/09)