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Right of Recovery
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Right of Recovery
If the plan pays benefits exceeding what should have paid under the coordination of benefits provision, the plan may recover the excess from one or more of:
  • The person it has paid or for whom it has paid
  • Insurance companies
  • Other organizations.
The amount of the payments includes the reasonable cash value of any benefits provided in the form of services.
A secondary plan that provides benefits in the form of services may recover the reasonable cash value of the services from the primary plan if the services are covered, but not paid or provided, by the primary plan. However, a plan is not required to reimburse a covered person in cash for the value of benefits provided in the form of services.
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© School District No. 1 Health and Welfare Trust  |  For PFSP, DCU and ATU employees |  Rev. August 2016