Page 20 - Εταιρικό Comprehenshive

18 Our team of Personal Advisers is available on +44 (0) 1892 556 276
What should I do if the benefits I am claiming for relate to an injury or
medical condition caused by another person?
4.5 You must tell us on the medical information form if you can claim any of the cost from
anyone else. If benefits are claimed for treatment to you when the injury or medical
condition was caused by some other person (the ‘third party’), we will pay those benefits
you can claim under the policy. If another insurance policy covers those benefits then we
will only pay our proper share of the benefits. However, in paying those benefits, we obtain
both through the terms of the policy and by law, a right to recover the amount of those
benefits from the third party.
In this case, the following shall apply:
• you must tell us as quickly as possible if you believe a third party caused the injury or
medical condition, or if you believe they were at fault. We may then write to you or the
third party if we require further information; and
• you must include all monies paid by us in respect of the injuries (and interest on those
monies) in your claim against the third party (‘our outlay’); and
• you (or your solicitors) must keep us fully informed about the progress of your claim and
any action against the third party or any pre-action matters; and
• you (or your solicitors) must keep us informed of the outcome of any action or
settlement (providing us with access to the details of any such settlement);
• should you successfully recover any monies from the third party they should be repaid
directly to us within 21 days of receipt on the following basis:
• if the claim against the third party settles in full, you must repay our outlay in full; or
• if you recover only a percentage of your claim for damages you must repay the same
percentage of our outlay to us; or
• if your claim is repaid as a global settlement (where our outlay is not individually
identified), you must repay our outlay in the same proportion as the global
settlement bears to your total claim for damages against the third party.
• If you do not repay to us such monies (and any interest recovered from the third party),
we shall be entitled to recover the same from you and your policy may be cancelled in
line with16.3(d)in the Complaint and Regulatory Information section.
The rights and remedies in this clause are in addition to and not instead of rights or
remedies provided by law.