SECTION 7 - GENERAL PROVISIONS (Continued)
When Must Lincoln be Notified of a Claim? 1. Notice of claim must be given to Lincoln within 20 days of the date of the loss on which the claim is based. If that is not possible, Lincoln must be notified as soon as it is reasonably possible to do so. Such notice of claim must be received in a form or format satisfactory to Lincoln. 2. When written notice of claim is applicable and has been received by Lincoln, you will be sent claim forms. If the forms are not received within 15 days after written notice of claim is sent, you can send to Lincoln written Proof of claim without waiting for the forms. When Must Lincoln Receive Proof of Claim? 1. Satisfactory Proof of loss must be given to Lincoln no later than 30 days after the end of the Elimination Period. 2. Failure to furnish such Proof within such time shall not invalidate or reduce any claim if it was not reasonably possible to furnish such Proof within such time. Such Proof must be furnished as soon as reasonably possible, and in no event, except in the absence of legal capacity of the claimant, later than one year from the time Proof is otherwise required. 3. Proof of continued loss, continued Disability or Partial Disability, when applicable, and Regular Attendance of a Physician must be given to Lincoln within 30 days of the request for such Proof. Lincoln reserves the right to determine if your Proof of loss is satisfactory. Who are Claims Paid To? The benefit is payable to you. But, if a benefit is payable to your estate, or if you are a minor, or you are not competent, Lincoln has the right to pay up to $1,000 to any of your relatives or any other person whom Lincoln considers entitled thereto by reason of having incurred expense for the maintenance, medical attendance or burial. If Lincoln in good faith pays the benefit in such a manner, any such payment shall fulfill Lincoln's responsibility for the amount paid. What are Lincoln's Rights of Recovery? Lincoln has the right to recover any overpayment of benefits caused by, but not limited to, the following: 1. fraud; 2. any error made by Lincoln in processing a claim within 15 months beginning on the date the claim was paid; or 3. your receipt of any Other Income Benefits. Lincoln may recover an overpayment by, but not limited to, the following: 1. requesting a lump sum payment of the overpaid amount; 2. reducing any benefits payable under this policy; 3. taking any appropriate collection activity available including any legal action needed; and 4. placing a lien, if not prohibited by law, in the amount of the overpayment on the proceeds of any Other Income Benefits, whether on a periodic or lump sum basis. It is required that full reimbursement be made to Lincoln.
ADOC-GNP-2.16
General Provisions
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