Benefit Claims Procedure Sample Clauses

Benefit Claims Procedure. (i) Any claim for the payment of benefits under this Agreement shall be made in writing to the Administrator. If such claim for benefits is wholly or partially denied, the Administrator shall, within ninety (90) days after receipt of the claim, notify the claimant of the denial of the claim. Such notice of denial: (A) shall be in writing; (B) shall be written in a manner calculated to be understood by the claimant; and (C) shall contain (I) the specific reason or reasons for denial of the claim, (II) a specific reference to the pertinent provisions of the Agreement upon which the denial is based, (III) a description of any additional material or information necessary to perfect the claim, along with an explanation of why such material or information is necessary, and (IV) an explanation of the claim review procedure.
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Benefit Claims Procedure. (a) Any claim for benefits under the Plan shall be made in writing to the Plan Administrator. If such claim for benefits is wholly or partially denied, the Plan Administrator shall, within thirty (30) days after receipt of the claim, notify the Participant or Beneficiary of the denial of the claim. Such notice of denial shall: (1) Be in writing; (2) Be written in a manner calculated to be understood by the Participant or Beneficiary, and (3) Contain: (A) The specific reason or reasons for denial of the claim, (B) A specific reference to the pertinent Plan provisions upon which the denial is based, (C) A description of any additional material or information necessary to perfect the claim, along with an explanation of why such material or information is necessary, and (D) An explanation of the claim review procedure in accordance with the provisions of this Article. (b) Within sixty (60) days after the receipt by the Participant or Beneficiary of a written notice of denial of the claim, or such later time as shall be deemed reasonable taking into account the nature of the benefit subject to the claim and any other attendant circumstances, the Participant or Beneficiary may file a written request with the Plan Administrator that it conduct a full and fair review of the denial of the claim for benefits. (c) The Plan Administrator shall deliver to the Participant or Beneficiary a written decision on the claim within thirty (30) days after the receipt of the aforementioned request for review, except that if there are special circumstances (such as the need to hold a hearing, if necessary) which require an extension of time for processing, the aforementioned thirty (30) day period shall be extended to sixty (60) days. Such decisions shall: (1) Be written in a manner calculated to be understood by the Participant or Beneficiary, (2) Include the specific reason or reasons for the decision, and (3) Contain a specific reference to the pertinent Plan provisions upon which the decision is based. (d) The decision of the Plan Administrator shall be final and binding on all parties, unless determined by a court of competent jurisdiction to be arbitrary and capricious.
Benefit Claims Procedure. (a) Any claim for benefits under the Plan shall be made in writing to the Administrator. If such claim for benefits is wholly or partially denied, the Administrator shall, within thirty (30) days after receipt of the claim, notify the Participant or Beneficiary of the denial of the claim. Such notice of denial shall:
Benefit Claims Procedure. (a) Any claim for benefits under the Plan shall be made in writing to the Plan Administrator. If such claim for benefits is wholly or partially denied, the Plan Administrator shall notify the Participant or Beneficiary of the denial of the claim within 90 days after receipt of the claim (or within 180 days, if special circumstances require an extension of time for processing the claim, and if written notice of such extension and cir- cumstances is given to the claimant within the initial 90-day period). Notwithstanding the foregoing, if a claim is for distribution of benefits under the Plan as a result of a Disability, written notice of the disposi- tion of the claim shall be furnished to the claimant within 45 days after the application is filed. If the claim is unable to be processed within the initial 45-day period for reasons beyond the control of the Plan Administrator, the time for reviewing the claim may be extended an additional 30 days provided that written notice of the extension is pro- vided to the claimant before the initial 45-day review period expires. If at the end of the 30-day extension period, the claim is still unable to be processed due to reasons beyond the control of the Plan Administrator, the time for reviewing the claim may be extended for an additional 30 days provided that written notice of the extension is provided to the claimant before the 30-day extension period expires. Such notice of denial shall:
Benefit Claims Procedure. (a) Any claim for money or stock awards under the Plan shall be made in writing to the Committee. If such claim is wholly or partially denied, the Committee shall, within ninety (90) days after receipt of the claim, notify the Participant or Beneficiary of the denial of the claim. Such notice of denial shall (i) be in writing, (ii) be written in a manner calculated to be understood by the Participant or Beneficiary, and (iii) contain the specific reason or reasons for denial of the claim, a specific reference to the pertinent Plan provisions upon which the denial is based, a description of any additional material or information necessary to perfect the claim, along with an explanation of why such material or information is necessary, and an explanation of the claim review procedure. The ninety (90) day period may, under special circumstances, be extended up to an additional ninety (90) days upon written of such extension to the Participant or Beneficiary which notice shall specify the special circumstances and the extended date of the decision. Notice of extension must be given prior to expiration of the initial ninety
Benefit Claims Procedure. 9.1 Any claim for benefits under the Plan shall be made in writing to the Committee. If such claim for benefits is wholly or partially denied, the Committee shall, within ninety (90) days after receipt of the claim, notify the Participant or Eligible Spouse of the denial of the claim. Such notice of denial (a) shall be in writing, (b) shall be written in a manner calculated to be understood by the Participant or Eligible Spouse, and (c) shall contain (1) the specific reason or reasons for denial of the claim, (2) a specific reference to the pertinent Plan provisions upon which the denial is based, (3) a description of any additional material or information necessary to perfect the claim, along with an explanation of why such material or information is necessary, and (4) an explanation of the claim review procedure. The ninety day period may, under special circumstances, be extended up to an additional ninety days upon written notice of such extension to the claimant which notice shall specify the extraordinary circumstances and the extended date of the decision. Notice of extension must be given prior to expiration of the initial ninety day period. If no notice of decision is given within the periods specified above, the claim shall, on the last day of the notice period, be deemed to have been denied and the Participant may file a request for review as provided in the next paragraph.
Benefit Claims Procedure. A claim for a benefit under the Plan by any person shall be filed in the manner and governed by the procedures set forth in the Agreement, which procedures are incorporated herein by reference.
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Benefit Claims Procedure. A claim for a benefit under the Plan by any person shall be filed in the manner and governed by the procedures set forth in the Agreement.
Benefit Claims Procedure. A claim for a benefit under the Plan by any person shall be filed in the manner and governed by the procedures set forth in the Agreement. Service Corporation International Split Dollar Life Insurance Plan 4 ARTICLE V
Benefit Claims Procedure. If CPC fails to timely make any payments or provide any benefits (including the benefit of continuing health, life and other insurance coverage provided under Section 4 hereof, but excluding claims under any such policy of insurance) that become payable under this Agreement, Monroe (or his widow) shall file a claim for such payments or benefits by notifying the Corporation orally or in writing. If the claim is wholly or partially denied, the Corporation shall provide a written notice to the claimant within fourteen (14) days after the claim is made specifying the reason for the denial, the provisions of the Agreement on which the denial is based, and any additional material or information necessary to receive the payments or benefits claimed. If no notice of denial by the Corporation is received by the claimant within said fourteen (14) day period, then the claim shall be approved for all purposes. If a claim is denied, in whole or in part, and a review of such denial is requested by Monroe (or his widow), the claimant shall notify the Corporation in writing within fourteen (14) days after the date upon which the claimant received the written notice of denial. In requesting such a review, the claimant may submit any additional material or information in support of the payments or benefits claimed. The Corporation, by and through its Board of Directors or a committee thereof, shall review the claim, denial and appeal of denial and provide a written notice modifying, affirming, or overruling, in whole or in part, the prior denial within fourteen (14) days following the date of the claimant's request for review of the denial, which written notice shall state the specific reasons for the Board's (or committee's) decision, including reference to the provisions of this Agreement on which the decision is based.
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