Common use of Claim Assessment Process Clause in Contracts

Claim Assessment Process. 3.2.1. After an Enrolled Program Claimant has been determined or deemed to be a Qualifying Program Claimant and such Person’s Program Claim has been Completed (as defined below), the Claims Administrator shall determine the number of Points that should be awarded to the Qualifying Program Claimant. The criteria, methodologies, formulae, guidelines and other terms and conditions for determining Points awards (collectively, the “Point Awards Criteria”) are (except for the terms of Section 3.4) set forth in Exhibit 3. 2.1. The analysis performed by the Claims Administrator shall be based solely on the terms and conditions of Exhibit 3.2. 3.2.1.1. The Claims Administrator shall process Program Claims in the order in which all of the following are satisfied in relation to Enrolled Program Claimants: (i) such Enrolled Program Claimant is determined or deemed to be a Qualifying Program Claimant pursuant to Article 2; and (ii) such Enrolled Program Claimant’s Program Claim is Completed. However, neither the Claims Administrator nor Merck shall have any Liability for any failure to do so. 3.2.1.2. A Program Claim shall be considered to have been “Completed” when the Claims Administrator determines that such Enrolled Program Claimant’s entire Claims Package has been provided to the Claims Administrator and such materials are not defective or deficient (or, if applicable, when such Enrolled Program Claimant is given a special dispensation pursuant to section 4(a) of Exhibit1.5, and such dispensation has become final, binding and Non-Appealable). 3.2.2. As outlined in Exhibit 3.2.1, Points assessment will consider (without limitation and among other factors as set forth in Exhibit 3.2.1) the extent of injury, age, consistency of VIOXX usage, duration of VIOXX usage, risk factors, and the date of the Related Eligible Event. 3.2.3. The Claims Administrator shall notify each Qualifying Program Claimant, Merck and the NPC of such Qualifying Program Claimant’s Points award using a form developed for such purpose by the Claims Administrator. Such Points award shall be subject to (i) appeal to the Special Master as set forth in Section 3.2.4, (ii) adjustment as set forth in Section 3.4 and (iii) Article 10, but otherwise shall be final, binding and Non-Appealable. 3.2.4. A Qualifying Program Claimant may appeal its Points award determination of the Claims Administrator to the Special Master by submitting a written notice to such effect to the Claims Administrator and the Special Master within fifteen

Appears in 3 contracts

Samples: Settlement Agreement, Settlement Agreement, Settlement Agreement

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Claim Assessment Process. 3.2.12.2.1. After an Enrolled The Claims Administrator shall review and analyze the Program Claimant has been determined Claims submitted by or on behalf of the Program Plaintiffs and those submitted by Plaintiffs’ Counsel pursuant to Section 5.2. 2.2.2. The Claims Administrator shall evaluate all Program Plaintiffs’ Program Claims based on the reasonable and objective criteria, methodologies, medical science, formulae, guidelines, categories, and other terms and conditions relevant in evaluating the Program Claims, which may include the type and extent of injury, age, age of onset, medical history, exposure history (including dates, length, and duration of such exposure to welding fumes), the type of welding consumables and fumes to which exposure occurred, other work history, the period from last exposure to welding fumes to the onset of the alleged injury, causation evidence, other risk factors present for the injuries alleged, and other criteria deemed relevant by the Claims Administrator in order to be evaluate the Program Claims in a Qualifying Program Claimant and reasonably consistent manner. Following such Person’s Program Claim has been Completed (as defined below)evaluation, the Claims Administrator shall determine whether a Program Plaintiff is entitled to a Program Award above the number $100 minimum payment provided for in Section 2.1.1 and, if so, determine the monetary amount of Points that should be awarded any additional Program Award pursuant to the Qualifying Program Claimant. The criteria, methodologies, formulae, guidelines and other terms and conditions for determining Points awards (collectively, the “Point Awards Criteria”) are (except for the terms of Section 3.4) set forth in Exhibit 33.1.1. 2.1. The analysis performed by the Claims Administrator shall be based solely on the terms and conditions of Exhibit 3.2. 3.2.1.12.2.3. The Claims Administrator shall process make Program Claims in Awards, including any additional monetary awards pursuant to Section 2.2, by awarding shares of the order in which Program Fund and determining at some later point the monetary value of each such share following a determination of all of the following are satisfied in relation Program costs and expenses and the amount of the Program Fund available to Enrolled pay Program Claimants: (i) such Enrolled Program Claimant is determined or deemed to be a Qualifying Program Claimant pursuant to Article 2; and (ii) such Enrolled Program Claimant’s Program Claim is CompletedAwards. However, neither nothing in this Section 2.2.3 permits a reduction in the minimum payment required by Section 2.1. 2.2.4. As part of the process of evaluating Program Claims, the Claims Administrator nor Merck may hire paralegal or administrative assistant(s), as needed in the discretion of the Claims Administrator. Any such hires shall have any Liability for any failure to do sobe compensated by the Program Fund, at a rate which shall be approved by a majority of the PLC and PEC. 3.2.1.22.2.5. A Program Claim shall be considered to have been “Completed” when The determinations of the Claims Administrator determines that such Enrolled in making Program Claimant’s entire Claims Package has been provided to the Claims Administrator and such materials Awards are not defective or deficient (or, if applicable, when such Enrolled Program Claimant is given a special dispensation pursuant to section 4(a) of Exhibit1.5, and such dispensation has become final, binding and Non-Appealable). 3.2.22.2.6. As outlined in Exhibit 3.2.1, Points assessment will consider (without limitation and among other factors as set forth in Exhibit 3.2.1) No notice or payment of Program Awards to Program Plaintiffs may be issued by the extent Claims Administrator until the Claims Administrator has determined the Program Awards of injury, age, consistency of VIOXX usage, duration of VIOXX usage, risk factors, and the date of the Related Eligible Eventall eligible Program Plaintiffs. 3.2.32.2.7. The Claims Administrator shall notify each Qualifying the Program ClaimantPlaintiffs and Plaintiffs’ Counsel of all Program Awards in writing, Merck and the NPC of such Qualifying Program Claimant’s Points award using a form developed for such purpose by the Claims Administrator. Such Points award shall be subject to (i) appeal to the Special Master as set forth in Section 3.2.4, (ii) adjustment as set forth in Section 3.4 and (iii) Article 10, but otherwise which awards shall be final, binding and Non-Appealable. 3.2.4. A Qualifying The Claims Administrator also will provide Defendants with the amount of the Program Claimant may appeal its Points award Award to be made to each Plaintiff and with each Plaintiff’s period of alleged exposure to welding fumes, to the best of the Claims Administrator’s information and belief, within five (5) days after completing the determination of the Claims Administrator to the Special Master by submitting a written notice to such effect to the Claims Administrator and the Special Master within fifteenProgram Awards.

Appears in 1 contract

Samples: Resolution Agreement (Thermadyne Holdings Corp /De)

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Claim Assessment Process. 3.2.1. After an Enrolled Program Claimant has been determined or deemed to be a Qualifying Program Claimant and such Person’s Program Claim has been Completed (as defined below), the Claims Administrator shall determine the number of Points that should be awarded to the Qualifying Program Claimant. The criteria, methodologies, formulae, guidelines and other terms and conditions for determining Points awards (collectively, the “Point Awards Criteria) are (except for the terms of Section 3.4) set forth in Exhibit 33.2. 2.11. The analysis performed by the Claims Administrator shall be based solely on the terms and conditions of Exhibit 3.2. 3.2.1.1. The Claims Administrator shall process Program Claims in the order in which all of the following are satisfied in relation to Enrolled Program Claimants: (i) such Enrolled Program Claimant is determined or deemed to be a Qualifying Program Claimant pursuant to Article 2; and (ii) such Enrolled Program Claimant’s Program Claim is Completed. However, neither the Claims Administrator nor Merck shall have any Liability for any failure to do so. 3.2.1.2. A Program Claim shall be considered to have been “Completed” when the Claims Administrator determines that such Enrolled Program Claimant’s entire Claims Package has been provided to the Claims Administrator and such materials are not defective or deficient (or, if applicable, when such Enrolled Program Claimant is given a special dispensation pursuant to section 4(a) of Exhibit1.5Exhibit 1.5, and such dispensation has become final, binding and Non-Appealable). 3.2.2. As outlined in Exhibit 3.2.1, Points assessment will consider (without limitation and among other factors as set forth in Exhibit 3.2.1) the extent of injury, age, consistency of VIOXX usage, duration of VIOXX usage, risk factors, and the date of the Related Eligible Event. 3.2.3. The Claims Administrator shall notify each Qualifying Program Claimant, Merck and the NPC of such Qualifying Program Claimant’s Points award using a form developed for such purpose by the Claims Administrator. Such Points award shall be subject to (i) appeal to the Special Master as set forth in Section 3.2.4, (ii) adjustment as set forth in Section 3.4 and (iii) Article 10, but otherwise shall be final, binding and Non-Appealable. 3.2.4. A Qualifying Program Claimant may appeal its Points award determination of the Claims Administrator to the Special Master by submitting a written notice to such effect to the Claims Administrator and the Special Master within fifteenfifteen (15) days of service of the Points award determination. The Special Master thereupon shall review such determination de novo. If, upon any such timely appeal, the Special Master determines that a determination of the Claims Administrator was in error, the Special Master either may return the matter to the Claims Administrator for a further determination (which itself may be appealed in the same manner as specified above) or may substitute its own determination for that of the Claims Administrator. All such determinations of the Special Master shall be final, binding and Non-Appealable. The Special Master shall notify the Claims Administrator of its determination, and the Claims Administrator shall, promptly following receipt of such notice, notify Counsel for the relevant Qualifying Program Claimant (or, if such Qualifying Program Claimant is without counsel, such Qualifying Program Claimant itself), Merck and the NPC of the Special Master’s determination.

Appears in 1 contract

Samples: Settlement Agreement (Merck & Co Inc)

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