| 4. | YOUR OBLIGATIONS AND DUTY OF COOPERATION. The Plan may, from time to time, require you to take such actions, give such information and assistance, and execute such documents as may be required to enforce the Plan's rights under this Appendix. The Plan will make no payments to you or on your behalf until the Trustees are satisfied that you comply with these requirements. For example, the Plan may require you and/or your representative to execute and deliver to the Plan any written document that the Plan may require to assist the Plan in its recovery, including a document that requires you, in any combination, to agree to (a) honor your obligation to reimburse the Plan; (b) assign the Plan all rights, claims, or causes of action you (or anyone acting on your behalf) has against any person or plan to the extent of benefits paid or payable under the Plan; and (c) warrant that neither you nor anyone on your behalf has not settled, discharged, or released any such right, claim, or causes of action against any person or plan, and that you shall not do so except as provided in this Plan. Nonetheless, no written document or assignment is essential to perfect the full and vested subrogation, restitution and set-off rights of the Plan, nor to your liability or the liability of the responsible person or plan. Nor shall the execution of such a document obligate the Plan to make conditional benefit payments if, in the exercise of their discretion, the Trustees conclude that the your actions or those of your representative are inconsistent with the Plan's rights under this Appendix. Further, it is the your express duty and responsibility to advise the Plan, in writing, of the existence of any potential or actual claim against any person or plan from the outset of your injury or illness, if another person or plan may be responsible to you because of the injury or illness. It is also your express duty and responsibility to cooperate fully with the Plan to effect its recovery under this Appendix. You and any person or entity acting on your behalf must hold in trust for the benefit of the Plan any amounts recovered to the extent of benefits paid by the Plan. Upon receipt of amounts paid by another person or plan, you must immediately notify the Plan and pay to the Plan all amounts due the Plan. If the Plan is forced to pursue litigation against you, your representative, or any other person or plan to recover amounts due under this Appendix, you will be required to reimburse the Plan all the costs of collection, including reasonable attorneys' fees. If you act to deprive the Plan of its subrogation, restitution or set-off rights by any action, omission, default, acceptance of payment, release of claims, or your failure to advise the Plan of the existence of a claim, potential claim, or recovery against another person or plan, the Plan may (a) recover from you any monies to which this Appendix applies, (b) set off proceeds due the Plan against future benefits under the Plan, whether for the injury in question or for any other illness or injury -- to the extent of benefits and other expenses paid by the Plan (including the Plan's expenses and legal fees) in securing such a recovery, or (c) terminate your coverage under the Plan. | |
| 5. | CONDITIONAL PAYMENTS IN CASE OF WRONGFUL DEATH. Where a covered person dies as a result of an injury or illness, and another covered person, in the judgment of the Trustees, has as a result of such death a cause of action for the deceased person's wrongful death, the otherwise covered expenses incurred by or on behalf of the deceased person prior to his death shall not be considered covered expenses under this Plan. Solely at the discretion of the Trustees, however, such expenses may be treated as conditionally covered expenses and be paid; provided, however that the covered person with the cause of action agrees, in consideration of the Plan's payment of such expenses, to reimburse the Plan according to the paragraphs of this Appendix governing subrogation, restitution and set-off. The surviving covered person has all of the obligations and duties described above under the heading "Your Obligations and Duty of Cooperation." All of the Plan's remedies d etailed under that heading may be used by the Plan. In addition, if the covered person with the cause of action fails to honor the obligation to reimburse the Plan, the Plan may sue the covered person or, as applicable, his heirs, guardians, executor, or other representative in order to recover the amounts due the Plan. In that case, the Plan shall also be entitled to reimbursement from the covered person of any and all costs of collection, including reasonable attorneys' fees. | |