星空无限传媒app

[Insert Name & Address Here]

Name:

Liquidator抯 Proof of Claim No.:

Address:

The Act established the New Jersey Insolvent Health Maintenance Organization Assistance Association ("Association") as a nonprofit legal entity to manage the funding and payment of certain eligible claims against HIP and APPP. As a condition of receiving payment directly from the Association for eligible claims, providers of health care services of the insolvent carrier agree to forgive one-third of the unpaid contractual obligations due them.

In addition, the Act provides that Claimant抯 claims may be subject to retrospective verification or audit and that all, or part, of any interim partial payment or distribution may be reclaimed by the Association as a result of the findings.

In consideration of this Estimated Second Interim Distribution from the Association, the Claimant agrees as follows:

1. REFUND of ESTIMATED SECOND INTERIM DISTRIBUTION

Claimant agrees that in the event it is determined that some or all of this Estimated Second Interim Distribution must be returned to the Association as a result of the Claimant receiving a distribution from the Association to which it was not entitled, the Claimant shall refund to the Association all or that portion of the Estimated Second Interim Distribution as requested by the Association within thirty (30) days of receipt of written request thereof.

The final determination with respect to reclaim situations will be based upon:

1. further developments as a result of the continued claim adjudication process by the insolvent carrier, and/or,
2. negligence, fraud or mistake by the Claimant.

Claimant抯 failure to remit all or a portion of the Estimated Second Interim Distribution to the Association within thirty (30) days of receipt of written request shall cause interest to accrue on and after the due date at the percentage of interest prescribed in the rules governing the Court of the 星空无限传媒app for judgments, awards and orders for the payment of money.

Claimant agrees to assign its rights to payments against the insolvent carrier to the Association with respect to this Estimated Second Interim Distribution.

3. ASSOCIATION扴 RIGHT to SETOFF

If the Association determines in good faith that the Claimant has failed to comply with any provision of this Estimated Second Interim Distribution Refunding Agreement, the Association retains the right, in addition to any other rights it may have, to setoff against any future disbursements to the Claimant the amount due to the Association and to withhold monies which would otherwise be distributable to the Claimant.

Further, upon finalizing the claim, if it is determined that multiple claims were filed for the same occurrence by related parties, the Association reserves the right to combine all such claims including any estimated interim distributions paid. Future claim payments, if any, as well as any right of recovery matters will be addressed with and through the recognized primary entity.

Any disputes arising in connection with this Agreement shall be resolved in accordance with the laws of the 星空无限传媒app.

Any notice required or permitted under the terms of this Agreement to be given to the parties shall be deemed given:

1. if actually received by the intended recipient by any means of manual delivery or electronic transmission;
2. (ii) if posted by prepaid certified mail, return receipt requested; or
3. (iii) if consigned to and receipted by a commercial delivery service and addressed as follows: