I assign my insurance benefits to be paid directly to Diba Tillery or Babies 411 LLC DBA My Pure Delivery. If insurance reimbursements are paid to me instead of the provider, I understand that it is not lawful to retain insurance reimbursement rightly due to the provider. In the event that I do retain any insurance reimbursements due to My Pure Delivery, all litigation and attorney fees to recoup such insurance reimbursement will be borne by me. *