Claim Review. If the Executive or the Executive's Beneficiary (a "Claimant") believes that he or she has been denied all or a portion of a benefit under this Agreement, he or she may file a written claim for benefits with the Company. The Company shall review the claim and notify the Claimant of the Company's decision within 60 days of receipt of such claim, unless the Claimant receives written notice prior to the end of the 60 day period stating that special circumstances require an extension of the time for decision. The Company's decision shall be in writing, sent by mail to the Claimant's last known address, and if a denial of the claim, must contain the specific reasons for the denial, reference to pertinent provisions of this Agreement on which the denial is based, a designation of any additional material necessary to perfect the claim, and an explanation of the claim review procedure.
Claim Review. Upon receipt of any written claim for benefits, the Plan Committee shall be notified and shall give due consideration to the claim presented. If the claim is denied to any extent by the Plan Committee, the Plan Committee shall furnish the claimant with a written notice setting forth (in a manner calculated to be understood by the claimant):
(a) the specific reason or reasons for denial of the claim;
(b) a specific reference to the Plan provisions on which the denial is based;
(c) a description of any additional material or information necessary for the claimant to perfect the claim and an explanation of why such material or information is necessary; and
(d) an explanation of the provisions of this Article.
Claim Review. If the Settlement Administrator suspects fraud or misleading conduct with respect to any Claim, the Settlement Administrator will immediately bring the Claim to the attention of Co-Lead Class Counsel and Counsel for NIBCO, who shall meet and confer with the Settlement Administrator concerning the Claim, and who reserve the right to bring the Claim to the attention of the Court.
Claim Review. If the Settlement Administrator suspects fraud or misleading conduct with respect to any Claim, the Settlement Administrator will immediately bring the Claim to the attention of Class Counsel and Counsel for Generac, who shall meet and confer with the Settlement Administrator concerning the Claim, and who reserve the right to bring the Claim to the attention of the Court or the appropriate authorities.
Claim Review. A claim review may be done only when a PARTICIPANT requests a review of denied BENEFITS. When a claim review has been completed, and the decision is to uphold the denial of BENEFITS, the PARTICIPANT shall receive written notification as to the specific reason(s) for the continued denial of BENEFITS and of his/her right to file a grievance. A CASE REVIEW OR CLAIM REVIEW MAY NOT BE SUBSTITUTED FOR A GRIEVANCE. GRIEVANCES REGARDING NONCOVERED SERVICES OR SERVICES EXCLUDED FROM COVERAGE BY THE HEALTH BENEFIT PLAN SHALL BE HANDLED LIKE ANY OTHER GRIEVANCE. GRIEVANCES SUBMITTED BY A HEALTH CARE PROVIDER CANNOT BE REFERRED TO THE CLAIM APPEAL UNIT.
Claim Review. Upon receipt of any written claim for benefits, the Administrator shall be notified and shall give due consideration to the claim presented. If the claim is denied to any extent by the Administrator, the Administrator shall furnish the claimant with a written notice setting forth (in a manner calculated to be understood by the claimant):
(a) the specific reason or reasons for denial of the claim;
(b) a specific reference to the Plan provisions on which the denial is based;
(c) a description of any additional material or information necessary for the claimant to perfect the claim and an explanation of why such material or information is necessary; and
(d) an explanation of the provisions of this Article.
Claim Review. Evaluate, and determine the validity of, Tier 1 Claims, as well as analyzing Tier 2 Claims in order to assist the Special Master;
Claim Review. Claims that are properly filed will be reviewed by the Compensation Committee or Administrative Committee, which will make its decision with respect to such claim and notify the Claimant in writing of such decision within 90 days after the Compensation Committee or Administrative Committee’s receipt of the written claim; provided that the 90 day period can be extended for up to an additional 90 days if the Compensation Committee or Administrative Committee determines that special circumstances require an extension of time to process the claim and the Claimant is notified of the extension, and the reasons therefor, prior to the commencement of the extension. If the claim is wholly or partially denied, the written response to the Claimant shall include:
(a) The specific reasons for the denial; SYMETRA FINANCIAL CORPORATION EXECUTIVE SEVERANCE PAY PLAN
(b) References to the specific provisions of the Plan document on which the denial is based;
(c) A description of any additional information necessary for the Claimant to perfect the claim and an explanation why such information is necessary;
(d) A description of the Plan’s claim appeal procedure (and the time limits applicable thereto), as set forth in Section 5.3; and
(e) A statement of the Claimant’s right to bring a civil action under XXXXX following an adverse determination on appeal.
Claim Review. After receiving the Customer’s Production Claim, Freedom Forever shall have the right to check Actual Annual kWh for the applicable Production Year and conduct on-site inspections on the Property for purpose of reviewing the production of the System and finding out the reasons, if any, which caused the Production Year Deficit. Within thirty (30) days after receiving the Customer’s Production Claim, Freedom Forever will notify the Customer of approval or rejection. In the event that Freedom Forever approves a Production Claim, which means a Production Year Deficit has occur and is not caused by any Exclusion Event, Freedom Forever will make a Production Year Deficit Payment, provided first that Freedom Forever has been permitted by Customer to upgrade the system pursuant to ARTICLE 2.4 in any way that would avoid future Production Claims.
Claim Review. The Claims Administrator shall review and evaluate each Claim Form, including any Valid Proof of Purchase submitted therewith, for validity, timeliness, and completeness. Failure to provide all information requested on the Claim Form will not result in immediate denial or nonpayment of a Claim. Instead, the Claims Administrator will take reasonable and customary steps to notify the Claimant of the Claim deficiency, including but not limited to, written e-mail notification when possible, requesting the additional information necessary to demonstrate eligibility. If, in the determination of the Claims Administrator, the Claimant completes a timely but incomplete Claim Form (e.g., the Claim Form is not signed; there is no Valid Proof of Purchase when it appears the Claimant intended to provide one or more Valid Proofs of Purchase; or there is an inadequate Valid Proof of Purchase), the Claims Administrator will take such steps to notify the Claimants of the Claim deficiency within thirty (30) days after the Claim Deadline or within thirty (30) days of receipt of a timely postmarked response, whichever is later. To cure the deficiency, the Claim Form deficiency response must be submitted via the online claim portal or postmarked within thirty (30) days after the mailing date of the notice of defect by the Claims Administrator and must cure the core defect of the Claim or the Claim will be denied. If the Claimant cures the deficiencies identified by the Claims Administrator within the thirty (30) day period following notice by the Claims Administrator, and the Claims Administrator thereafter determines that the Claimant’s Claim is complete and valid, the Claims Administrator shall include the Claimant in the Class Member Payment List. Claim Forms shall be reviewed and evaluated for deficiencies in the order in which they are received, to the extent practicable. Class Counsel and Defense Counsel shall have the right to review the Claim files of the Claims Administrator at any time. The Claims Administrator shall have the right to confer with Class Counsel and Defense Counsel with respect to any Claim.
