Common use of Adverse Benefit Determination Due to Failure to Resolve Appeals or Grievances Within Prescribed Timeframes Clause in Contracts

Adverse Benefit Determination Due to Failure to Resolve Appeals or Grievances Within Prescribed Timeframes. (A) Failure of the Contractor to act within the prescribed timeframes provided for resolving and giving resolution notice for Appeals or Grievances constitutes an Adverse Benefit Determination. The Contractor shall provide a Notice of Adverse Benefit Determination to the Aggrieved Person at the time the Contractor determines the time frame for resolving the Appeal or Grievance will not be met.

Adverse Benefit Determination Due to Failure to Resolve Appeals or Grievances Within Prescribed Timeframes. (A) Failure of the Contractor to act within the prescribed timeframes provided for resolving and giving resolution notice for Appeals or Grievances constitutes an Adverse Benefit Determination. The Contractor shall provide a Notice of Adverse Benefit Determination to the Aggrieved Person at the time the Contractor determines the time frame timeframe for resolving the Appeal or Grievance will not be met.