Claim Review Sample Clauses
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. The parties’ claim representatives shall meet in good faith within fifteen (15) days of the submission of a Claim to endeavor to resolve the Claim on their own. If the parties are unable to resolve the Claim in this manner, the Claim shall be mediated as set forth below.
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 Lead Class Counsel and Counsel for Bow, 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 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. 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 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. 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. 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. 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. If the Claim Administrator issues a Claim Denial, and if the Settlement Class Member who submitted that Claim submits a Claim Review Request Form (or other information, documents, data and materials sufficient to constitute all of the information required for a complete Claim Review Request Form) to the Claim Administrator within thirty