Misrepresentation or Falsification of Claim and Wrongfully Paid Benefits

If the Plan erroneously pays benefits because of false information or misrepresentations entered on your enrollment form, claim form or required documentation, or as a result of a mistake, then the Plan will be entitled to:

• A refund from you or your healthcare Provider of the difference between the amount paid by the Plan for those expenses and the amount of Plan benefits that should have been paid by the Plan for those expenses based on the actual facts, or
  
  
• An offset of future benefits to recover such expenses, and
  
  
• A recovery from you of the Plan’s attorney’s fees, costs and expenses incurred in recovering monies that were wrongfully paid because of such misrepresentation or falsification.