Claims Account Clause Samples
A Claims Account clause establishes a dedicated account for the management and settlement of claims arising under a contract. Typically, this account is used to hold funds set aside by one or both parties to cover potential liabilities, such as damages or indemnities, that may be claimed during the course of the agreement. By segregating these funds, the clause ensures that resources are readily available to address claims efficiently, thereby reducing disputes over payment and providing financial security for both parties.
Claims Account. AUL agrees to perform the following services with respect to the collection of amounts due to the Company and the maintenance of the Claims Account:
(i) AUL shall diligently seek to collect all Premium, reinsurance recoverables and other funds due to the Company in connection with Covered Business and any Outward Reinsurance and the ARL Retrocession and promptly (but in no event later than 5 Business Days following receipt) deposit such payments into a separate Bermuda bank account which shall be owned and established by the Company and to which AUL shall have full access and authority to make deposits and withdrawals (the “Claims Account”). All Premiums, reinsurance recoverables and other funds received by AUL on behalf of [***]: CONFIDENTIAL PORTIONS OMITTED AND FILED SEPARATELY WITH THE COMMISSION. the Company pursuant to this Agreement shall be held by AUL in a fiduciary capacity for the benefit of the Company prior to being deposited in the Claims Account. AUL shall have the right to withdraw from the Claims Account Underwriting Fees, Run Off Fees and Employee Leasing Fees, expenses, taxes or other amounts due to AUL upon receipt by the Company of an invoice therefor and all other amounts to be paid by AUL on behalf of the Company pursuant to this Agreement in respect of claim payments under Covered Contracts, premiums under Outward Reinsurance and the ARL Retrocession and any adjustment or return premiums (“Permitted Claims Account Withdrawals”). AUL shall make no deductions from the Claims Account other than Permitted Claims Account Withdrawals unless authorized in writing by the Company.
(ii) In the event that the Company receives any Premiums, reinsurance recoverables or other funds that AUL is authorized to collect pursuant to this Agreement, the Company shall promptly return such amounts to the broker with the instructions for them to deliver such amounts correctly to AUL (and shall copy AUL on such correspondence).
(iii) The Company shall promptly deliver to AUL each month a copy of the monthly Claims Account Cash Flow Estimate (as defined in the Investment Management Agreement) delivered to the Investment Manager and AUL shall advise the Company whether it concurs with the Projected Claims Liquidity Need (as defined in the Investment Management Agreement) and whether amounts in the Claims Account are expected to be sufficient to satisfy expected Permitted Claims Account Withdrawals. If the amount in the Claims Account is or is expected to be i...
Claims Account. War Lake acknowledges that a portion of the payment being made by Hydro pursuant to section 2.2 is to be used to cover the payment of Members’ Claims, and accordingly, the Indenture requires the establishment of a Claims Account to cover Members’ Claims.
Claims Account. The Claims Account shall be utilized for the payment of claims and settlements. All contribution of members intended for claims and settlements, and earnings thereon, shall be deposited to the Investment Account and shall be invested as provided in Article V. The Administrator shall be authorized to withdraw funds from the Investment Account to transfer to the Claims Account for the purpose of paying claims. The Administrator and the Board of Directors shall be authorized to withdraw funds from the Claims Account upon such conditions as the Board may direct.
Claims Account. A Claims Account shall be established. The capital of the Claims Account shall be used for the following purposes:
(a) for the payment of claims and costs (including the remuneration of a
(b) in accordance with Article 16.1 for indemnification payments required to be made pursuant to Section 10.3 of the Agreement.
Claims Account. The Company and the Employer shall establish and maintain those banking arrangements, including the Claims Account, described in Exhibit C to the Agreement. In addition to its obligations under Exhibit C, the Employer shall fund the Claims Account as necessary to enable the Company to pay in a timely manner from the Claims Account the Health Benefits described in section 2(a).
(i) If the Employer does not maintain the banking arrangements required in this section or in Exhibit C, including any required balance, the Company will provide notice to the Employer so that it can take corrective action, and the Company may terminate the Agreement in accordance with section 4 of the Agreement.
(ii) After a reasonable period of time as determined by the Company, the Company shall place stop payment instructions on Checks issued pursuant to the Agreement that are not Paid. The Company shall be responsible for complying with applicable abandoned property laws, if any, with respect to any Checks that are not Paid prior to the termination of the Agreement. Any amount transferred to a state in compliance with such laws shall be treated as Paid on the date that the transfer is made.
(iii) Upon termination of the Agreement, the Claims Account shall be closed as soon as reasonably practicable after the Company determines that all Health Benefits required to be Paid from the Claims Account have been Paid, and any funds remaining in the Claims Account shall be recovered by the Employer, subject to the Company’s right to offset such funds against amounts owed to it under the Minimum Premium Arrangement.
Claims Account. (a) For purposes of paying claims and claims related expenses, the Company shall establish, fund and maintain a separate bank account ("Claims Account') which the Administrator may draw against as provided in this Agreement.
(b) The Company shall fund the Claims Account with amounts necessary to pay all claims and "Legal Loss Adjustment Expenses", which term, as used in this Agreement, means legal costs and expenses incurred by the Administrator and allocated by it to the investigation, adjustment and settlement or defense of claims for benefits under the Policies, including without imitation, attorneys' fees and disbursements, pre and post judgment interest, court reporter services and transcripts, deposition charges and transcripts, fees for service of process, court costs, appeal bonds, printing costs related to trials and appeals, fees of witnesses amid experts, medical examination and review, laboratory costs, vehicle and property damage appraisals, surveillance, photography, and similar costs reasonably incurred and related to the investigation and defense of claims or the protection and prosecution of subrogation rights of the Company. Legal Loss Adjustment Expenses shall also include additional compensation paid to the Administrator to the extent recoverable under the Reinsurance Agreements, a schedule of which will be provided to Clarendon upon request. Legal Loss Adjustment Expenses shall exclude all Administrators' Expenses (as later defined). The Administrator shall, on a regular basis, provide the Company with information and estimates to enable the Company to maintain the Claims Account at an appropriate level. In no event shall the Claims Account be funded in an amount greater than three (3) months estimated claims payments and Legal Loss Adjustment Expenses.
(c) Checks drawn on the Claims Account by the Administrator, or its agents or employees, shall be signed and issued only in accordance with procedures agreed upon in advance by the Company and the Administrator. In any ease, checks drawn on the Claims Account must be signed by two (2) authorized officers or employees of the Administrator, whose names and positions shall be promptly reported to the Company. To issue any check or checks aggregating in excess of $50,000 for any one claim, thc Administrator shall first send a fax request to the Company for authority to do so and shall not issue such check or checks until it receives specific authorization therefor by fax from the Company.
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Claims Account. Fox Lake acknowledges that a portion of the payment being made by Hydro pursuant to subsection 2.2.2 is to be used to cover the payment of Citizens’ Claims advanced before and after the Date of this Agreement, and accordingly, a Claims Account has been established under the Indenture to cover the cost of these claims.
Claims Account. TMG shall maintain a claims account ("Claims Account") upon which HPS shall be authorized to draw checks or drafts to pay Claims and Allocated Loss Adjustment Expenses. The Claims Account shall be owned by TMG and shall be so identified on check stock.
Claims Account. (a) The Board assumes all financial responsibility for claims submitted for Covered Individuals to Contractor, whether by Participating Pharmacies or Covered Individuals. Board shall initiate Automated Clearinghouse (“ACH”) transfers to Contractor within two business days of receipt of Contractor invoices as authorized below.
(b) Prior to the effective date of this Contract, under the provisions of the previous contract, the Board provided to Contractor sufficient funds to hold within Contractor’s account(s) an amount at least equal to three-fourths (3/4) of one month’s prescription claims and administrative fees.
(1) Effective July 1, 2011, ▇▇▇▇▇▇▇ will begin reimbursing the Board, annually, one-fifth the amount of the claims and administrative fees previously provided to the Contractor.
(2) Reimbursement to the Board over the next five years will be made as distinct payments to the Department and will not be made as adjustments to administrative or other fees paid to Contractor.
(3) In the event the contract is terminated prior to the full five years any outstanding balance Contractor owes the Board will revert to the Board in one lump sum, within 14 calendar days of the termination of the contract.
(c) Billing and payment cycles for pharmacy claims and administrative fees will occur twice monthly. Billing and payment cycles for claims submitted directly by Covered Individuals will occur monthly. Billing and payment cycles may be modified if mutually agreed upon by Contractor and Department. Contractor will electronically send invoices, in forms satisfactory to both parties, to Board as follows:
Claims Account. The parties acknowledge that claims under the Plan are to be paid from a separate fund account established by the City. City shall be solely responsible for funding said account. City shall not name UHS or represent that UHS is, and UHS shall not be, a trustee or custodian over the account or the Plan. Prior to the effective date of this Agreement, City shall arrange to initiate Automated Clearinghouse ("ACH") transfers from the City account to a UHS account which UHS will use to pay claims. No such amounts which are to be or are transferred to UHS shall be considered Plan assets. UHS shall also be given the right to access information regarding the balance in City's account from which ACH transfers are being made. At the end of each claims processing time period, UHS shall provide notice to City via telephone of the amount necessary to pay claims processed. City shall, within 48 hours following receipt of notice from UHS, initiate ACH transfers from the City account to a UHS account in an amount necessary to pay the claims processed by UHS. In the event that for any reason funds are not available to complete an ACH transfer in the required amount and City fails to cause the account to provide the required amount of funds within the required 48 hours following notice of the need to provide such funds, UHS shall have the right to terminate this Agreement immediately and may provide notice of such termination to Preferred Providers and Covered Persons. In the event that City has at any time failed to make funds available to pay claims for Health Services or has failed to pay fees to UHS, in addition to any other remedies, UHS shall have the right to arrange an offset of any unpaid amounts against any amounts owed to City by UHS, or any entity affiliated with UHS. City acknowledges and agrees that the UHS accounts into which money from City is transferred may contain money from one or more other sponsors of self-insured health plans or health plans under contract with UHS for administrative services. City also acknowledges and agrees that any and all interest earned from such UHS account(s) shall belong to UHS.