Benefits are payable only if you submit timely and adequate proof of your claim.
Benefits are payable to the claimant whose Injury or Sickness is the basis for a claim under the Plan, except that in the case of the Retiree’s death, any applicable Death Benefits are paid in accordance with the Beneficiary provisions for Accidental Death and Dismemberment Benefits. The Plan will generally pay network Hospitals, Physicians, or any other network Provider directly.
If any individual is, in the opinion of the Trustees, legally incapable of giving a valid receipt for any payment due and no guardian has been appointed for that individual, the Trustees may, at their discretion, make such payment to the person or persons who, in the opinion of the Trustees, have assumed the care and principal support of such individual. If the individual should die before all amounts due and payable have been paid, the Trustees may, at their option, make such payment to the executor, administrator or personal representative of his or her estate or to his surviving spouse, parent, Child or Children, or to any other person or persons who are entitled to such payment, in the Trustees’ opinion.
Any payments made by the Trustees in accordance with these provisions will fully discharge the liability of the Trustees to the extent of such payment.