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2005-040
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2005-040
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Last modified
7/7/2016 10:57:11 AM
Creation date
9/30/2015 7:45:12 PM
Metadata
Fields
Template:
Official Documents
Official Document Type
Agreement
Approved Date
02/01/2005
Control Number
2005-040
Agenda Item Number
7.S.
Entity Name
SAFECO Life Insurance Company
Subject
Excell Loss Insurance Policy Participation Agreement
Archived Roll/Disk#
4000
Supplemental fields
SmeadsoftID
3876
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CLAIMS PROVISIONS (continued ) <br /> AUDIT <br /> SAFECO , or its duly authorized representative(s ) , prior to making a reimbursement, will have the right to <br /> inspect and audit all of the Participating Employer's and the Participating Employer's Claims <br /> Administrator's records and procedures as well as any other records and procedures that pertain to this <br /> Policy. SAFECO will also have the right to require proof that payment of Covered Expenses has been <br /> made . <br /> SUBROGATION <br /> In the event of any payment(s) of Covered Expenses under the Employee Benefit Plan due to an illness <br /> and/or injury to a Covered Unit or Covered Family Unit caused by a third party, the Participating Employer <br /> may be entitled to a recovery from such third party. SAFECO retains the right to pursue any recovery <br /> received by the Participating Employer and to collect any and all reimbursements made to the <br /> Participating Employer. In the event SAFECO recovers an amount greater than its reimbursement, the <br /> excess , reduced by the costs to obtain the recovery, will be returned to the Participating Employer. <br /> SAFECO is entitled to first recovery of payments as an offset to the deductible paid by the Participating <br /> Employer. <br /> If the Participating Employer receives a recovery prior to SAFECO reimbursing any Covered Expenses <br /> under the Policy, the Participating Employer must deduct these payments from any reimbursement <br /> request. If the Participating Employer receives a recovery after SAFECO has made reimbursement for <br /> some or all of a particular claim , then the Participating Employer must reimburse SAFECO to the extent of <br /> the reimbursement within 30 days . <br /> The obligation of the Participating Employer to reimburse SAFECO remains , regardless of whether the <br /> Policy is still in force on the date of recovery. In addition , this provision is applicable even if it is determined <br /> the amount of the Covered Unit' s or Covered Family Unit's recovery does not fully indemnify or make <br /> whole the Covered Unit or Covered Family Unit, The Participating Employer's payment to SAFECO may <br /> be reduced by the reasonable and necessary expenses incurred in recovering from the other party. <br /> LGC 8815 03/02 3 <br />
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