Subrogation and Reimbursement

The Boston University Health Plan also has a subrogation and reimbursement rule. If another party is, or is claimed to be, responsible (the “responsible party”) for an illness or injury inflicted on you or a covered dependent, the Health Plan is entitled to reimbursement out of any recovery from the responsible party (or any insurer, including any liability insurer, uninsured or underinsured motorist insurer, or homeowner insurer) for amounts expended by the plan for health care to the covered individual. The covered individual must cooperate with the Health Plan to recover such amounts. If the covered individual receives payment from the responsible party (or any insurer, including any liability insurer, uninsured or underinsured motorist insurer, or homeowner insurer) before the Health Plan receives amounts expended for such individual’s care, the covered individual must hold any amount recovered from the responsible party in trust for the benefit of the Health Plan to the extent of amounts paid by the Health Plan for care, and must repay the Health Plan from the amounts recovered even if the amounts recovered do not fully compensate the covered individual for all of his or her losses, damages, or expenses.

The Health Plan’s Right to Repayment will not be reduced by attorneys’ fees or other expenses incurred by a covered individual. The Health Plan will not pay any portion of those attorneys’ fees or expenses.