31A-29-119 - Benefit reduction.
31A-29-119. Benefit reduction.
(1) The pool shall be the last payer of benefits whenever any other benefit is available.
(2) Benefits otherwise payable under pool coverage shall be reduced by:
(a) all amounts paid or payable through any other health benefit plan or any limitedhealth benefit plan, including a self-insured plan;
(b) all hospital and medical expense benefits paid or payable under any workers'compensation coverage, automobile medical payment, or liability insurance, whether provided onthe basis of fault or no-fault; and
(c) any hospital or medical benefits paid or payable under or provided pursuant to anystate or federal law program.
(3) The board shall have a cause of action against an enrollee for the recovery of theamount of benefits paid which are not for covered expenses. Benefits due from the pool may bereduced or refused as a set-off against any amount recoverable under this Subsection (3).
Amended by Chapter 385, 2008 General Session