Level II Your appeal will be reviewed by a panel that includes health care providers and is different from the Level I panel. You and/or your authorized representative may meet with the panel. The panel will give you a decision within 30 calendar days of the date we receive your Level II request. Right Of Recovery We have the right, upon demand, to recover payments for which the plan was not liable that were made to any of the following: • Any insurance company • Any other organization • You or on your behalf • Someone who is not eligible to receive benefits Refunds of such payments or overpayments will be requested from the party to whom the payments were made. If reimbursement is not made, and such payment or overpayment was sent to you, recovery may be made through deductions from future benefits. However, recovery in this manner will only be made when the payment for such future benefits could have legally been made directly to you. It is not the intent of the plan that you recover (from all sources) more than the total incurred medical expenses. Third Party Liability We have the right to be reimbursed for the amount of benefits we provided because of a condition or injury for which you are not legally liable. As explained below, reimbursement may be sought by you or by us from the party who is legally liable or from that party's insurance carrier. You must notify us of any action or claim for a condition or injury for which we paid benefits. This includes promptly notifying us in writing of all of the following matters: • The facts of your condition or injury; • Any changes in your condition or injury; • The name of any person responsible for your condition or injury, and that person's insurance carrier; and • Advance notice of any settlement you intend to make of your action or claims. If you bring an action or claim against another person, you must also seek recovery of the benefits we paid under this contract. We may, however, assert our right to recover benefits directly from the other person, or from you. If we do so, you do not need to take any action on our behalf. You must, however, do nothing to impair our right of recovery. Should we assert our right of recovery directly, we have the right to join as a party in the action or claim you brought. In recovering benefits we have provided, we may either hire our own attorneys, or be represented by your attorney. If we choose to be represented by your attorney, we will pay, on a contingent basis, a reasonable portion of the attorney's fees which are necessary and which benefit our rights of recovery in the case. Usually, this portion will not be more than 20 percent of the amount we seek to recover. We will not pay for any legal costs incurred by you as the subscriber, or for costs incurred on your behalf. 13 Group Plan G/Dis