Georgia Health Insurance Information on Subrogation

The Plan reserves the right to be reimbursed for benefits paid under this Plan if the person for whom benefits are paid has a right to recover these benefits from a third party. This is called subrogation. This provision helps control the cost of the Plan by limiting certain recoveries to the actual medical expense lost. In no instance shall a Participant be asked to reimburse more than the actual medical expenses paid on the Participant's behalf.

Right of Subrogation
If a Participant incurs medical expenses as the result of injuries suffered because of the alleged negligence or misconduct of another person, the Participant may have a claim against that person for payment of medical bills. The Plan will be subrogated to the right of recovery the Participant has against the other person.

This right shall be only to the extent of benefits paid by the Plan for medical expenses. The Participant will be required to reimburse the Plan out of any monies the Participant receives from the other person or his or her insurance company as a result of judgment, settlement or otherwise. The Participant will be required to furnish the Plan information and assistance required to enforce this right of subrogation. The purpose of this provision is to help provide insurance at reasonable rates. Subrogation will be administered by the Claims Administrator.