Claims Submission We will submit your claims and assist you in any way we reasonably can to help get your claims paid. Your insurance company may need you to supply certain information directly. It is your responsibility to comply with their request. Please be aware that the balance of your claim is your responsibility whether or not your insurance company pays your claim. Your insurance benefit is a contract between you and your insurance company; we are not party to that contract.
Claim Form i. Within 15 days after receiving a notice of a claim, you or your Dental Provider will be provided with a Claim Form to make claim for Benefits. To make a claim, the form should be completed and signed by the Provider who performed the services, and by the patient (or the parent or guardian if the patient is a minor), and submitted to the address above.
Claims Payment The Reinsurer will be liable to the Company for its share of the benefits owed under the express contractual terms of the Reinsured Policies and as specified under the terms of this Agreement. The Reinsurer will not participate in any ex gratia payments made by the Company (i.e., payments the Company is not required to make under the Reinsured Policy terms.) The payment of death benefits by the Reinsurer will be in one lump sum regardless of the mode of settlement under the Reinsured Policy. Benefit payments from the Reinsurer will be due within 30 days of the claim satisfying the requirements established under this Agreement. The Reinsurer’s share of any interest payable under the terms of a Reinsured Policy or applicable law which is based on the death benefits paid by the Company, will be payable provided that the Reinsurer will not be liable for interest accruing on or after the date of the Company’s payment of benefits. The Reinsurer will make payment to the Company for each such claim. For Waiver of Premium claims, the Company will continue to pay premiums for reinsurance, except premiums for disability reinsurance. The Reinsurer will pay its proportionate share of the gross premium waived by the Company on the Reinsured Policy, including its share of the premiums for benefits that remain in effect during disability. For claims on Accelerated Benefit riders reinsured under this Agreement, the benefit amount payable by the Reinsurer will be calculated by multiplying the total accelerated death benefit rider payout by the ratio of the reinsured Net Amount at Risk, as defined in Exhibit C-1, to the face amount of the Reinsured Policy.
FINAL BILLING SUBMISSION Unless otherwise provided by the System Agency, Grantee shall submit a reimbursement or payment request as a final close-out invoice not later than forty-five (45) calendar days following the end of the term of the Contract. Reimbursement or payment requests received after the deadline may not be paid.
Claim Procedure Any Person entitled to indemnification hereunder shall (i) give prompt written notice to the indemnifying party of any claim with respect to which it seeks indemnification (provided that the failure to give prompt notice shall impair any Person’s right to indemnification hereunder only to the extent such failure has prejudiced the indemnifying party) and (ii) unless in such indemnified party’s reasonable judgment a conflict of interest between such indemnified and indemnifying parties may exist with respect to such claim, permit such indemnifying party to assume the defense of such claim with counsel reasonably satisfactory to the indemnified party. If such defense is assumed, the indemnifying party shall not be subject to any liability for any settlement made by the indemnified party without its consent (but such consent shall not be unreasonably withheld, conditioned or delayed). An indemnifying party who is not entitled to, or elects not to, assume the defense of a claim shall not be obligated to pay the fees and expenses of more than one counsel for all parties indemnified by such indemnifying party with respect to such claim, unless in the reasonable judgment of any indemnified party a conflict of interest may exist between such indemnified party and any other of such indemnified parties with respect to such claim. In such instance, the conflicted indemnified parties shall have a right to retain one separate counsel, chosen by the Holders representing a majority of the Registrable Securities included in the registration if such Holders are indemnified parties, at the expense of the indemnifying party.
Submitting False Claims; Monetary Penalties The AOC shall be entitled to remedy any false claims, as defined in California Government Code section 12650 et seq., made to the AOC by the Contractor or any Subcontractor under the standards set forth in Government Code section 12650 et seq. Any Contractor or Subcontractor who submits a false claim shall be liable to the AOC for three times the amount of damages that the AOC sustains because of the false claim. A Contractor or Subcontractor who submits a false claim shall also be liable to the AOC for (a) the costs, including attorney fees, of a civil action brought to recover any of those penalties or damages, and (b) a civil penalty of up to $10,000 for each false claim.
Payment Claims Subject to clause 11.3, the Contractor must give the PDS Contractor claims for payment on account of the Contract Price and all other amounts then payable by the Commonwealth to the Contractor under the Contract: at the times specified in the Contract Particulars until Completion or termination of the Contract (whichever is earlier); unless terminated earlier: after Completion, within 28 days (or such longer period agreed in writing by the PDS Contractor) after the issue of a Completion certificate under clause 13.1; and after the Defects Liability Period, within the time required by clause 11.9; in the format set out in the Schedule of Collateral Documents or in any other format which the PDS Contractor reasonably requires; which are based on the Table of Variation Rates and Prices or the Schedule of Rates to the extent these are relevant; which show separately the amounts (if any) claimed on account of the: Contract Price; and all other amounts then payable by the Commonwealth to the Contractor under the Contract; and which set out or attach sufficient details, calculations, supporting documentation and other information in respect of all amounts claimed by the Contractor: to enable the PDS Contractor to fully and accurately determine (without needing to refer to any other documentation or information) the amounts then payable by the Commonwealth to the Contractor under the Contract; and including any such documentation or information which the PDS Contractor may by written notice from time to time require the Contractor to set out or attach, whether in relation to a specific payment claim or all payment claims generally.
Civil Penalty Payment Pursuant to Health and Safety Code§ 25249.7(b)(2), and in settlement of all claims alleged in the Notice or referred to in this Settlement Agreement, XXXX agrees to pay Three Thousand Five Hundred Dollars ($3,500.00) in civil penalties. The penalty payment will be allocated in accordance with California Health and Safety Code§§ 25249.12(c)(1) & (d), with 75% of the penalty amount paid to the California Office of Environmental Health Hazard Assessment ("OEHHA") and the remaining 25% of the penalty amount retained by CRC. Within ten (10) days of the Effective Date, VIGO shall issue a check to “OEHHA” in the amount of Two Thousand Six Hundred and Twenty-Five Dollars ($2,625.00) and shall, pursuant to the instructions below, wire to CRC the amount of Eight Hundred and Seventy-Five Dollars ($875.00). All payments owed to OEHHA (EIN: 00-0000000) pursuant to this Section shall be delivered directly to OEHHA (Memo Line "Prop 65 Penalties") at the following addresses: For United States Postal Delivery Service: Xxxx Xxxxxxx Fiscal Operations Branch Chief Office of Environmental Health Hazard Assessment P.O. Box 4010, MS 19B Sacramento, CA 95812-4010 For Non-United States Postal Delivery Service: Xxxx Xxxxxxx Fiscal Operations Branch Chief Office of Environmental Health Hazard Assessment 0000 X Xxxxxx XX #00X Sacramento, CA 95814 All penalty payments owed to CRC shall be sent via wire to: Wire & ACH Instructions: Account Name: The Law Offices of Xxxxxx X. Xxxxxxx Bank Name: X.X. Xxxxxx Xxxxx Bank, N.A. Bank Address: 000 Xxxx Xxx. New York, NY. 10017 ACH Routing / ABA Number: 000000000 Wire Routing / ABA Number: 000000000 Account Number: 802922919 For further benefit of: Civil Penalty Payment File No. P65-0389
Verification of payment claims Project promoters shall submit interim and final project reports containing information on project progress and incurred expenditure. In line with point i) of Article 5.6.2 of the Regulation incurred expenditure reported shall be subject to administrative verifications before the report is approved. Verifications to be carried out shall cover administrative, financial, technical and physical aspects of projects, as appropriate, and be in accordance with the principle of proportionality. Examination of proof of expenditure related to the administrative verifications may be carried out on a sample basis. Additionally, in line with point ii) of Article 5.6.2 of the Regulation on–the-spot verifications of projects, which may be carried out on a sample basis, shall be carried out. The detailed procedure for verification will be further detailed in the description of the Programme Operator’s management and control systems.
CLAIM PROCEDURES Claim forms or claim information as to the subject policy can be obtained by contacting Benmark, Inc. (800-544-6079). When the Named Fiduciary has a claim which may be covered under the provisions described in the insurance policy, they should contact the office named above, and they will either complete a claim form and forward it to an authorized representative of the Insurer or advise the named Fiduciary what further requirements are necessary. The Insurer will evaluate and make a decision as to payment. If the claim is payable, a benefit check will be issued in accordance with the terms of this Agreement. In the event that a claim is not eligible under the policy, the Insurer will notify the Named Fiduciary of the denial pursuant to the requirements under the terms of the policy. If the Named Fiduciary is dissatisfied with the denial of the claim and wishes to contest such claim denial, they should contact the office named above and they will assist in making an inquiry to the Insurer. All objections to the Insurer's actions should be in writing and submitted to the office named above for transmittal to the Insurer.