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Whether You or The Plan makes a claim directly against any party for the benefit payments made to You or on your
behalf by The Plan, The Plan has a lien on any amount You recover or could recover from the party whether by judgment,
settlement, or otherwise, and whether or not designated as payment for lost wages. This lien shall remain in effect until
The Plan and releases its lien. The lien may not be for an amount greater than the amount of benefits paid under The
Plan.
The Plan Administrator has discretionary authority with regard to asserting The Plan’s subrogation, reimbursement and
recovery rights.
Third Party as used in this provision means any person or legal entity whose act or omission, in full or in part, causes
You to suffer a Disability for which benefits are paid or payable under The Plan.
Legal Actions: When can legal action be taken against the Employer?
No auction at law or in equity shall be brought to recover benefits from The Plan:
1) sooner than 90 days after all information with respect to a claim for benefits has been filed and the appeal
process has been completed in accordance with the requirements of The Plan; or
2) more than 3 years from the date Proof of Loss is required to be furnished according to the terms of The Plan.
Misstatements and Fraud: What happens in the event of misstatements and/or fraud?
If material facts about You were not stated accurately, the true facts will be used to determine if, and for what amount,
coverage should have been in force. If, for the purpose of obtaining or continuing to obtain benefits under The Plan, You
or anyone acting on Your behalf makes, or causes to be made, a false statement or misrepresentation, conceals or
withholds information, commits fraud against The Plan, or otherwise misleads The Plan, The Plan shall be entitled to
recover its damages, including benefits paid and legal fees, from You or from any other person responsible for misleading
or committing fraud against The Plan. The Plan will assert all legal and equitable rights against You and/or any other
person responsible for misleading or committing fraud against The Plan and pursue all legal and equitable remedies The
Plan has against You and/or any other person responsible for misleading or committing fraud against The Plan.
Overpayment Recovery: What happens in the event of an overpayment?
Whenever payments have been made from The Plan to You (or on Your behalf) in excess of the benefits to which You (or
a person Related to You) are entitled under The Plan, including an overpayment due to (i) a false or misleading
statement, misrepresentation, concealment or withholding of information, or fraud by You or anyone acting on Your
behalf, (ii) a claims processing error, or (iii) Your receipt of Other Income Benefits (including retroactive awards received
from sources listed in the Other Income Benefits definition), You, Your estate, a person Related to You, or any other
person to whom benefits are paid on Your behalf will be required to reimburse The Plan in an amount equal to the excess
payments. The Plan Sponsor or Claims Evaluator will determine the method by which the repayment is to be made. It
may be possible to reduce or eliminate future payments instead of requiring repayment. Further, if the initial attempts to
recover an overpayment are not successful, the overpayment amount will be withheld from Your wages or other
compensation, to the extent permitted by applicable law. In addition, the Plan (or the Claims Evaluator or Plan Sponsor
on behalf of The Plan), will have the right to recover the excess payments by an action at law or equity.
Assignment and Transfer: May Plan benefits be assigned or transferred?
No assignment of benefits shall be binding on The Plan. Except as otherwise provided herein, no person other than an
Eligible Person is entitled to receive benefits under the Plan. Such right to benefits is not transferable.
Incapacity and Lost Participants: What happens if a person entitled to a Plan benefit is incapacitated or lost?
If, in the opinion of the Plan Administrator, an individual for whom a claim has been made is incapable of furnishing a valid
receipt of payment due him/her under The Plan and, in the absence of written evidence to The Plan of the qualification of
a guardian or personal representative for the individual’s estate, the Plan Administrator may, on behalf of The Plan, in its
sole discretion, make any and all such payments to the person providing for the care and support of such individual. Any
payment so made will constitute a complete discharge of The Plan’s obligation to the extent of such payment.
Any benefit payable hereunder shall be deemed forfeited if the Plan Administrator is unable to locate an individual to
whom payment is due, provided, however, that such benefit shall be reinstated if a claim is made by the individual for the
forfeited benefit within one (1) year.
Social Security: When must I apply for Social Security Benefits?
The Employer may require that You apply for Social Security disability benefits when the length of Your Disability meets
the minimum duration required to apply for such benefits. You must apply within 45 days from the date of the request. If
the Social Security Administration denies Your eligibility for benefits, You will be required:
1) to follow the process established by the Social Security Administration to reconsider the denial; and