Claim for Appeal Must be Submitted within 60 Days Sample Clauses

Claim for Appeal Must be Submitted within 60 Days. The claimant and/or his representative may appeal the denied claim, free of charge, provided that such appeal is made within 180 days of the date the claimant receives a notification of the denied disability claim. The decision of the claimant as to whether or not to submit a benefit dispute to this voluntary level of appeal will have no effect on the claimant’s rights to any other benefits under the Plan. The Committee’s review shall take into account all comments, documents, records and other information submitted by the claimant relating to the claim, regardless of whether such information was submitted and/or considered in the initial determination. In the review of a claim for disability benefits, the following shall apply: a. A review shall not afford deference to the initial denial and shall be conducted by a named fiduciary of the Plan who is neither the individual who made the adverse benefit determination that is the subject of the appeal, nor a subordinate or such individual; b. The named fiduciary who is reviewing the appeal and making a determination based, in whole or in part, on medical judgment shall consult with a health care professional who (i) has appropriate training and experience in the field of medicine involved in the medical judgment, (ii) did not consult with respect to the initial adverse benefit determination that is the subject of the appeal, and (iii) is not a subordinate of an individual who consulted with respect to the initial adverse benefit determination that is the subject of the appeal; and