Claims Administrator Procedure (CAP)
When a claims processing question arises under the Settlement Agreement that needs
clarification or requires the Claims Administrator’s exercise of discretion, the
Claims Administrator may promulgate a Claims Administrator Procedure “CAP”. CAPs
shall be consistent with the terms of the Settlement Agreement and with the intent of the
Parties to the Settlement Agreement and shall be not be interpreted to be inconsistent
with the Settlement Agreement. Any person making an objection to any proposed CAP shall
submit that objection to the Claims Administrator in writing. Pursuant to Section 9.1 of
the Settlement Agreement, the Court retains the exclusive and continuing jurisdiction to
interpret and enforce the terms and conditions of the Settlement Agreement.
When a CAP is completed and signed by the Claims Administrator it will be posted to the website at this address and an email advisory will be sent to all Class Members and their Attorneys letting them know the CAP is publicly available. Email advisories of new CAPs are intended to keep the Class Members and Parties to the Settlement Agreement advised of developments in the Settlement. When you receive a new CAP email advisory, it is for informational purposes and is not an indication that there is any problem with your Claim. If the Claims Administrator has a question regarding your Claim for Settlement benefits, the Office of the Claims Administrator will contact you by letter or phone call.
Please click the links below to view the full text version of each CAP in PDF format:
To view documents in PDF Format, you must have Adobe Acrobat Reader installed on your computer. This program may be downloaded for free from the Adobe website by clicking the button below:
CAP No. 1
Establishment of System for Creating and Tracking Sulzer Settlement Trust Claims Administrator Procedures
CAP No. 2
Statement and Itemization of Litigation Expenses in BLUE, ORANGE, RED, and GREEN Forms
CAP No. 3
Payment of Settlement Benefit Checks to Class Members and to Attorneys Representing Class Members
CAP No. 4
Proof that an Affected Product Revision Surgery is for a Reason Other Than Trauma
CAP No. 5
Direct Payment of Attorney Fee Benefits from Plaintiffs’ Counsel Sub-Fund When Multiple Attorneys Represent a Class Member
CAP No. 6
Claims Pursuant to Agreements Between Sulzer and Third Party Payors Against the Subrogation and Uninsured Expenses Sub-Fund
CAP No. 7
Application of Advances or Other Payments Made by Sulzer to Reduce Class Member Benefits
CAP No. 8
Approval of Claims Administrator Contracts by the Court
CAP No. 9
Contingent Fee Contracts Entered into after February 2, 2002
CAP No. 10
Rescission of Opt-Out by Submitting Claim for Settlement Benefits
CAP No. 11
Computation of Deadlines and Time Limits
CAP No. 12
Claims by Insurers Not Already a Party to a Settlement Agreement with Sulzer
CAP No. 13
Clarifying Timeliness Requirements for Amendments and Supplements of Certain Extraordinary Injury Fund Claims
CAP No. 14
Assisting Unrepresented Class Members with Completion of Claim Forms
CAP No. 15
Proof of United States Residence or Citizenship
CAP No. 16
Claims by Lien Filers Asserting a Lien Against Class Members' Settlement Benefits
CAP No. 17
Clarifying Consequences of Class Member's Abandonment of Claim
CAP No. 18
Establishing Deadlines for Qualifying Event Under Matrix Levels I, II, and IX Extraordinary Injury Benefit Claims for Claims Based on Implantation of an Inter-Op Shell or Tibial Baseplate
CAP No. 19
Board Certification for Physician Declaration
CAP No. 20
[Reserved]
CAP No. 21
Inapplicability of Section 3.6(d) Offsets for Advance Payments Made by Sulzer for Medical Expenses
CAP No. 22
Clarifying Sulzer's Payment of Certain Claims related to Reprocessed Shells
CAP No. 23
Health Care Provider Requests for Payment of Unpaid Coinsurance and Deductible Bills
CAP No. 24
[Reserved]
CAP No. 25
Blue Form Submission EIF Level I, Level II, or Level IX Claims Predicated on Implantation of Reprocessed Shells
CAP No. 26
Definition of Significant Other in the Context of Derivative Claimants
CAP No. 27
Claims Administrator's Exercise of Discretion in Reviewing Claims for Benefits under the Extraordinary Injury Fund.
CAP No. 28
APRS Fund Benefits if Revision Surgery Requires Multiple Procedures
CAP No. 29
Extensions for Claim Processing and Submission Deadlines for Class Members
CAP No. 30
Procedures for Appealing a Final Determination
CAP No. 31
Clarifying Sulzer's Payment of Certain Claims related to Inter-Op Shells and Tibial Baseplates
CAP No. 32
Benefit Amounts for Matrix Level I (APRS Medical Contraindication) and II (Non-Removal Surgery) Extraordinary Injury Fund Claims
CAP No. 33
Extraordinary Injury Fund Claims for Lost Income and Future Medical Expenses Pursuant to Matrix Level IX
CAP No. 34
Awarding Benefit Amounts for Extraordinary Injury Fund Claims
| PLEASE BE ADVISED THAT FINAL NOTICE IN
THIS MATTER WAS SENT TO CLASS MEMBERS DURING MARCH 2002. IF YOU BELIEVE THAT YOU ARE A
CLASS MEMBER AND DID NOT RECEIVE FINAL NOTICE BY MARCH 2002, PLEASE CONTACT: © 2002 - Sulzer Implant Settlement. All Rights Reserved. |