Common use of REDUCTIONS – THIRD PARTY LIABILITY Clause in Contracts

REDUCTIONS – THIRD PARTY LIABILITY. If a Member is injured or becomes ill due to the act or omis- sion of another person (a “third party”), Blue Shield or a con- tracted Dental Plan Administrator shall, with respect to Services required as a result of that injury, provide the Bene- fits of the Plan and have an equitable right to restitution, re- imbursement or other available remedy to recover the amounts Blue Shield paid for Services provided to the Mem- ber from any recovery (defined below) obtained by or on be- half of the Member, from or on behalf of the third party responsible for the injury or illness or from unin- sured/underinsured motorist coverage. This right to restitution, reimbursement or other available remedy is against any recovery the Member receives as a re- ▇▇▇▇ of the injury or illness, including any amount awarded to or received by way of court judgment, arbitration award, set- tlement or any other arrangement, from any third party or third party insurer, or from uninsured or underinsured motor- ist coverage, related to the illness or injury (the “Recovery”), without regard to whether the Member has been “made whole” by the Recovery. The right to restitution, reimburse- ment or other available remedy is with respect to that portion of the total Recovery that is due for the Benefits paid in con- nection with such injury or illness, calculated in accordance with California Civil Code Section 3040. The Member is required to:

REDUCTIONS – THIRD PARTY LIABILITY. If a Member is injured or becomes ill due to the act or omis- sion of another person (a “third party”), Blue Shield or a con- tracted Dental Plan Administrator shall, with respect to Services ser- vices required as a result of that injury, provide the Bene- fits Benefits of the Plan and have an equitable right to restitution, re- imbursement reimburse- ment or other available remedy to recover the amounts Blue Shield paid for Services services provided to the Mem- ber Member from any recovery re- covery (defined below) obtained by or on be- half behalf of the MemberMem- ber, from or on behalf of the third party responsible for the injury in- jury or illness or from unin- sureduninsured/underinsured motorist coveragecover- age. This right to restitution, reimbursement or other available remedy rem- edy is against any recovery the Member receives as a re- ▇▇▇▇ result of the injury or illness, including any amount awarded to or received re- ceived by way of court judgment, arbitration award, set- tlement settlement or any other arrangement, from any third party or third party insurer, or from uninsured or underinsured motor- ist motorist coverage, related to the illness or injury (the “Recovery”), without regard to whether the Member has been “made whole” by the RecoveryRecov- ery. The right to restitution, reimburse- ment reimbursement or other available remedy is with respect to that portion of the total Recovery that is due for the Benefits paid in con- nection connection with such injury or illness, calculated in accordance with California Civil Code Section 3040. The Member is required to:

REDUCTIONS – THIRD PARTY LIABILITY. If a Member is injured or becomes ill due to the act or omis- sion of another person (a “third party”), Blue Shield or a con- tracted Dental Plan Administrator shall, with respect to Services ser- vices required as a result of that injury, provide the Bene- fits Benefits of the Plan and have an equitable right to restitution, re- imbursement ▇▇▇▇- bursement or other available remedy to recover the amounts Blue Shield paid for Services services provided to the Mem- ber Member from any recovery (defined below) obtained by or on be- half behalf of the Member, from or on behalf of the third party responsible for the injury or illness or from unin- sureduninsured/underinsured motorist coverage. This right to restitution, reimbursement or other available remedy is against any recovery the Member receives as a re- ▇▇▇▇ of the injury or illness, including any amount awarded to or received by way of court judgment, arbitration award, set- tlement or any other arrangement, from any third party or third party insurer, or from uninsured or underinsured motor- ist mo- torist coverage, related to the illness or injury (the “RecoveryRecov- ery”), without regard to whether the Member has been “made whole” by the Recovery. The right to restitution, reimburse- ment or other available remedy is with respect to that portion of the total Recovery that is due for the Benefits paid in con- nection with such injury or illness, calculated in accordance with California Civil Code Section 3040. The Member is required to:

REDUCTIONS – THIRD PARTY LIABILITY. If a Member is injured or becomes ill due to the act or omis- sion omission of another person (a “third party”), Blue Shield or a con- tracted contracted Dental Plan Administrator Adminis- trator shall, with respect to Services required as a result of that injury, provide the Bene- fits Benefits of the Plan and have an equitable right to restitution, re- imbursement or other available remedy to recover the amounts Blue Shield paid for Services provided to the Mem- ber Member from any recovery (defined below) obtained by or on be- half behalf of the Member, from or on behalf of the third party responsible for the injury or illness or from unin- sureduninsured/underinsured motorist coverage. This right to restitution, reimbursement or other available remedy is against any recovery the Member Mem- ber receives as a re- ▇▇▇▇ result of the injury or illness, including in- cluding any amount awarded to or received by way of court judgment, arbitration award, set- tlement settlement or any other arrangement, from any third party or third party insurer, or from uninsured or underinsured motor- ist motorist coverage, related to the illness or injury (the “Recovery”), without regard to whether the Member has been “made whole” by the Recovery. The right to restitution, reimburse- ment reimbursement or other available remedy is with respect to that portion of the total Recovery that is due for the Benefits paid in con- nection connection with such injury or illness, calculated in accordance with California Civil Code Section 3040. The Member is required to: