A member or enrolled dependent may be compensated for an illness or injury for which another party is liable to pay damages. In these cases that party has the primary payment responsibility and Yale Health has the legal right to be reimbursed for services covered or provided by Yale Health. If a Yale Health member brings legal action or otherwise makes a claim against a third party allegedly responsible for his or her condition that Yale Health member agrees to:
- Notify the Yale Health Billing Department as soon as possible and to keep Billing informed at all times of subsequent developments.
- Reimburse Yale Health for its costs and services out of any resulting settlement to the full extent permitted by law.
- Cooperate in protecting the interests of Yale Health under this provision and execute and deliver to Yale Health or its nominees any and all documents (e.g. accident reports) requested by Yale Health that may be necessary to effectuate and protect its rights.
- Yale Health will provide medical care upon a member’s request with the understanding that the member will reimburse Yale Health in full for any treatment rendered or expense incurred on his or her behalf without deductions of any nature, including attorney’s fees, to the full extent permitted by law.