Ill. Admin. Code tit. 50 § 2020.40

Current through Register Vol. 48, No. 49, December 6, 2024

Section 2020.40 - Reimbursement Provision

Right of Reimbursement: In addition to any other requirements set forth in the Code or Department regulations, if an insurer includes a reimbursement provision in its policy, that provision shall be in the form set forth in subsection (a)(1) if the insurer has the right to first reimbursement, or subsection (b) if the insurer does not have the right to first reimbursement:

a) "If a covered person recovers expenses for sickness or injury that occurred due to the negligence of a third party, we have the right to first reimbursement for all benefits we paid from any and all damages collected from the negligent third party for those same expenses whether by action at law, settlement, or compromise, by the covered person, the covered person's parents if the covered person is a minor, or the covered person's legal representative as a result of that sickness or injury. You are required to furnish any information or assistance, or provide any documents that we may reasonably require in order to exercise our rights under this provision. This provision applies whether or not the third party admits liability."

b) "If a covered person recovers expenses for sickness or injury that occurred due to the negligence of a third party, we have the right to reimbursement for all benefits we paid from any and all damages collected from the negligent third party for those same expenses whether by action at law, settlement, or compromise, by the covered person, covered person's parents if the covered person is a minor, or covered person's legal representative as a result of that sickness or injury. You are required to furnish any information or assistance, or provide any documents that we may reasonably require in order to exercise our rights under this provision. This provision applies whether or not the third party admits liability."

Ill. Admin. Code tit. 50, § 2020.40

Amended at 31 Ill. Reg. 14723, effective October 22, 2007