Back

If the Plan erroneously pays benefits, 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 from you and/or your Dependents to recover such expenses, and
     
  • If the erroneous payment was due in whole or in part to misstatements, omissions, fraud or wrongful acts, the Plan is entitled to recovery from you or the responsible Provider of the Plan’s attorney’s fees, costs and expenses incurred in recovering monies that were erroneously paid because of such misrepresentation or falsification together with the greater of the Plan’s actual earnings or interest thereon.