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<br />d. it is understood that the Administrator will perform its duties as defined above in a consistent <br />manner within the scope of its daily operation in review and adjudication of claims on your <br />behalf. <br /> <br />AUDIT: We shall have the right to inspect and audit all records and procedures of you and your <br />Administrator. We may require. upon request, proof of records satisfactory to Us that payment has <br />been made to the Covered Person or the provider of such services or benefits which are the basis of <br />any claim hereunder. <br /> <br />HOLD HARMLESS: The Company agrees to hold the Reinsurer harmless for any legal expenses <br />incurred or judgment(s) awarded arising out of any dispute involving a participant or former <br />participant of the Company's Benefit Plan covered by this agreement as respects any participant's <br />claim of any rights under the Company's Benefit Plan provided such legal expenses or judgments were <br />not incurred as a result of the sole negligence or intentional wrongful acts of the Reinsurer. <br /> <br />NOTICE OF CLAIM: You shall give written notice of claims to Us on a form provided by Us within <br />30 days of the date you become aware of the existence of facts which would reasonably suggest the <br />possibility that benefits will be incurred which are covered by this Treaty. You shall provide written <br />notification to Us when benefits have been incurred which are covered by this Treaty. You shall <br />provide written notification to Us when benefits have been incurred by the Covered Person which are <br />equal to exceed 50% of the Specific Retention Amount. Your failure to furnish such written notice <br />within 30 days shall not invalidate nor reduce any claim if it was not reasonably possible to give such <br />written notice within that time, provided that such written proof of loss is furnished no later than I year <br />after the date that written notice of claims is otherwise provided and that the claim has been paid by <br />you within the term of that Treaty Year, subject to the other provisions of that Treaty Year. <br /> <br />You shall also notify Us immediately when a Covered Person incurs Eligible Expenses for any of the <br />following diagnoses: <br /> <br />1. Acquired Immune Deficiency Syndrome - AIDS <br />2. Head or Spinal Cord Injury <br />3. Malignant Tumors of the brain, liver or pancreas <br />4. Premature Birth <br />5. Severe Burn Cases <br />6. Severe Stroke <br />7. Severe Trauma <br /> <br />You and your Administrator shall submit on a timely basis all proofs, reports and supporting <br />documents requested by Us. <br /> <br />NOTICE OF APPEAL: Any objection, notice of legal action, or complaint received on a claim <br />processed by you or your Administrator, and on which it reasonably appears benefits will be payable <br />under this Treaty, shall be brought to the immediate attention of our Claims Department. <br /> <br />SUBROGATION: You shall prosecute any and all valid claims that you may have against third parties <br />arising out of any claim for which benefits were paid by the Plan. You or your Administrator shall <br />account to Us for all amounts recovered. If you or your Administrator fails to pursue any action against <br />a third party and We have made excess benefit payments under this Treaty, We shall be subrogated to <br />all of your rights. You shall cooperate fully and do all things necessary and required for Us to pursue <br />any action to recover against the third party. <br /> <br />Any amounts recovered by you. your Administrator or the Covered Person in such action shall be used <br />first to reimburse the expenses of recovery and then to reimburse Us for any excess payments made on <br />behalf of any Covered Person. Any amounts recovered by Us shall be used to pay the expenses of <br />collection and reimburse Us for any amount that We may have paid or become liable to pay to you <br />under the terms of this Treaty. All amounts thus remaining shall be paid to you. <br /> <br />10 <br />