DESIGNATION OR CHANGE OF BENEFICIARY: Each Plan Participant may designate a beneficiary to whom loss of life benefits are payable. The designation shall be as follows in descending order:
1) Beneficiaries designated in writing by the Plan Participant for the Policy on file with the Policyholder, if any, otherwise;
2) Beneficiaries as designated in writing for any group life insurance plan or its renewals in force for the Policyholder, if any, otherwise;
3) In equal shares to the members of the first surviving class of those that follow, if any: a) a Plan Participant’s lawful Spouse, if not legally separated or divorced, or Domestic Partner or Civil Union Partner; Liaison International b) a Plan Participant’s natural Child, adopted Child, foster Child, stepchild, or other Child for whom the Plan Participant has or had legal guardianship (proof will be required); or c) a Plan Participant’s parents, whether natural, step or adoptive; or d) a Plan Participant’s sisters or brothers, otherwise.
4) The estate of the Plan Participant. A Plan Participant may change his/her beneficiary designation from time to time without the consent of the designated beneficiary by giving notice, in writing, to the Policyholder. When a request for designation or change is received by the Policyholder, it will take effect on the date of its execution, whether or not the Plan Participant is living on the date it is received by the Policyholder. Any interest created by the request will be subject to any payment made or action taken before its receipt. A Dependent’s beneficiary is the Plan Participant. If no beneficiary is living on the date of a Dependent’s death, the beneficiary is the Plan Participant’s estate.
PHYSICAL EXAMINATION AND AUTOPSY: We have the right to have a Physician of Our choice examine the Plan Participant as often as is reasonably necessary. This section applies when a claim is pending or while benefits are being paid. We also have the right to request an autopsy in the case of death. We will pay the cost of the examination or autopsy.
RECOVERY OF OVERPAYMENT: If benefits are overpaid, or paid in error We have the right to recover the amount overpaid or paid in error by any of the following methods. 1) A request for lump sum payment of the amount overpaid or paid in error or 2) Reduction of any proceeds payable under the Policy by the amount overpaid or paid in error.
RECOVERY OF BENEFITS: We reserve the right to recover from a Plan Participant any benefits We have paid to him for injuries: (1) Received in a covered Accident; and (2) Which are covered under: (a) workers' compensation or similar statutory remedies available under law; or b) Any employer's liability Insurance. It will be assumed that the Plan Participant is in receipt of such benefits unless he gives us proof such benefits have been denied to him. “Recovery” means monies paid to the Plan Participant through judgment, settlement or otherwise to compensate for all losses caused by the Injury.
RIGHT OF REIMBURSEMENT / SUBROGATION: If a Plan Participant 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 Plan Participant, the Plan Participant's parents if the Plan Participant is a minor, or the Plan Participant'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. We are assigned the right to recover from the negligent Third Party, or his or her insurer, to the extent of the benefits We paid for 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.
LEGAL ACTIONS:
No legal action may be brought to recover on the Policy within 60 days after written Proof of Loss has been furnished. No legal
action may be brought after three (3) years from the time written Proof of Loss is required to be furnished.
Claims documents must be signed and submitted within 90 days from the date of service via postal mail, fax or email attachment.