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<br />possible to have given proof ~ithin such time, provided such proof is <br />furnished as soon as reasonably possible and in no event, except in <br />the abse~ce of legal capacity of the Covered Person, later than one <br />year from which the time prc~f is otherwise required. <br /> <br />Payment ClaillS <br /> <br />All benefits will be paid upon receipt of written proof by Health <br />Plan. Whe~e applicable, benefits under this Contract will be paid to <br />the Enrollee. Subject t~ written authorization from an Enrollee, all <br />or a portion of any benefits due may be paid directly to the provider <br />of' th~ se~'vices. <br /> <br />Legal Action <br /> <br />No action at law or in equity shall be brought to recover on this <br />C,::>ntt'act pt'iot' to the expit'at i,)n of ninety (90) days after pt',).:)f I::>f <br />loss has been filed in accordance with the requirements of this <br />Contract, nor shall such action be brought at all unless brought <br />within three (3) years from the expiration of the time within which <br />proof of loss is required by this Contract. <br /> <br />SECTION IV <br />COORDINATION OF BENEFITS; <br /> <br />SUBROGATION <br /> <br />Coordination of Benefits <br /> <br />For the purpose of this section: <br /> <br />"Plarr" means <br />artY worker"~ s <br />act, which <br />received. <br />pol icies <br /> <br />any plan of health care coverage, including but not limited to <br />compensation, employet"s liability insurance or similar law I::>t' <br />provides health care services or indemnifies for services <br />Excluded are individual accident or health or automobile <br />Ot' Med icaid. <br /> <br />"P~'ifllary Resp.:rr"lsibility" mearrs the ,:obligation ,:of a PlaYI to provide its <br />services ¡:Ot' benefits first. Any eligible expenses not then covered are t,::> <br />be covet'ed by whichever Planes) is (at'e) not considered to have Primary <br />Resp,:ons i bi I i ty. <br /> <br />If any Covered Person is eligible for services or benefits under two or <br />mm'e Plar,s, the covet'age under' thclse Plans wi 11 be col:Ot'dinated so that up <br />to, but not more than, lØØ~ of any Eligible Expenses will be paid for, or <br />provided by, all such Plans combined. Primary Responsibility for providing <br />these set'vices or' benefits will be dater'mirled in the fQllowirlg Qrdet': <br /> <br />(1) <br /> <br />The benefits of a PlaYI wh ich covers the pet'son l:on wh':ose expenses claim <br />is based other than as a dependent shall be determined before the <br />benefits of a Plan whi~h covers such person as a dependent. <br /> <br />(':-1 <br />,..., <br /> <br />The benefits of a Plãn which CQvers the persQn on whose expenses claim <br />is based as a depe~dent of ~ person whQse date of birth, excluding <br />year' ,::f bit'th, :JCCUt'S earlier' in a Calendar' Year', shall be detet'mined <br />befo~'e tho:;! benefits c:f a Plan wh ich C::'Vt?t'S sl.lch pet'son as a dependent <br />:_,{"- a ;:it:~""30(J ,.,;hc.se da.t.? clf bit'th, excli.\d:ng year' I:)f bit'th, 1:'CCUt'S later' <br /> <br />GU-12-10 <br />