Board Agenda - February 05, 2008

g. Subrogation Settlement Agreement

Presenter: Jeff Bailey

Purpose: A - Request decision - closure required

Time: No time limit

Description:

The Plano ISD Employee Health Benefit Plan (Plan) pays in advance for claims resulting in accidents where third-party involvement is present. In these instances, the covered member accepts subrogation (Exhibit A from the 2008 Plan document) to reimburse the Plan, when a settlement from other insurance is finalized. Some settlements are not always for the total amount expended by the Plan, especially when the third-party is uninsured. In these instances an agreement is made, based on the total amount available in the insurance limits of the insurance policies available.

We are recommending settlement for no less than approximately 1/2 of the insurance funds available to a covered member, injured in a motor vehicle accident, for $15,192.83. (Details regarding this claim are provided in a separate document, to satisfy HIPAA regulations). While this is less than the expended funds for this claim, it is approximately 1/2 of the benefits available to the member. However, by accepting this agreement, the district is assured of receiving no less than this amount offset claims paid.

Recommendation:

Approve the settlement agreement for no less than $15,192.83.

Business Impact:

None

Summary:

Appendix:

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