Common use of Claims Administration Clause in Contracts

Claims Administration. The Service Provider shall administer claims on the Reinsured Policies as appropriate, including the following: (a) Reviewing and paying all claims for benefits which the Service Provider's review determines to be qualified for payment in accordance with applicable Reinsured Policy provisions. Any such payments shall be made within the time periods and in the manner prescribed by Applicable Law. Each payment made by the Service Provider with respect to claims subject to this Agreement shall, where appropriate, be made in full and final discharge of the obligations of the Company or the Service Provider under the applicable Reinsured Policy with respect to such payment; (b) Reviewing and (subject to Section 6.03 of this Agreement) compromising or denying, as is appropriate based on the guidelines of the Company in effect immediately prior to the Effective Date, all claims for benefits which the Service Provider's review determines to be qualified for such denial or compromise, in reliance on applicable Reinsured Policy provisions. In the event of non-payment of claims on account of incomplete or insufficient data, the Service Provider shall acknowledge such fact to the claimant by the earlier of (i) ten (10) Business Days from date of receipt of the claim or (ii) the number of days provided by Applicable Law; (c) Communicating with claimants with respect to the submission, approval and payment, compromise or denial of claims made under the Reinsured Policies; (d) Maintaining such files and records as are necessary to enable the Company, at any time, to determine the true and accurate claim experience on the Reinsured Policies; (e) Conforming to the reasonable requirements set by the Company for monthly submission of claims reports; (f) Performing such other claim services as may be reasonably required in connection with the support and administration of the Reinsured Policies; (g) Preparing all Federal Tax reports and state tax reports required by Applicable Law, including without limitation 1099-R, 1099-INT, 1099MISC, W-2P, W-2 and 5498 for policyholders and beneficiaries as required, and distributing the same to policyholders and beneficiaries and appropriate authorities; (h) Responding to any requests from plan administrators or trustees for policy information affecting the plan or participants for qualified plans; (i) Responding to requests for calculations applicable to annuity payments as may be necessary for Tax calculations; (j) Responding to requests for partial claims, including but not limited to waiver of premium riders, nursing home provisions, and waiver of monthly deduction; and (k) Cooperation with Company efforts to facilitate fraud detection and investigation that may relate to both the Reinsured Policies and other business of the Company or its affiliates. (l) Administering payouts on annuity contracts, in the event of the death of the owner of the contract, in conformance with contract provisions and the applicable provisions of the Code.

Claims Administration. The Service Provider Claims Administrator shall, subject to the supervision of the Court, administer the relief provided by this Settlement Agreement by processing Claim Forms in a cost effective and timely manner. The Claims Administrator shall administer claims on the Reinsured Policies maintain reasonably detailed records of its activities under this Settlement Agreement. The Claims Administrator shall maintain all such records as appropriate, including the following: (a) Reviewing and paying all claims for benefits which the Service Provider's review determines to be qualified for payment are required by applicable law in accordance with applicable Reinsured Policy provisions. Any its normal business practices and such payments shall records will be made within available to Class Counsel and the time periods GEICO COMPANIES’ Counsel promptly upon request. The Claims Administrator shall also provide reports and other information to the Court as the Court may require. The Claims Administrator shall promptly upon request provide Class Counsel and the GEICO COMPANIES’ Counsel with information concerning Notice, administration and implementation of the Settlement Agreement. Should the Court request or should it be reasonably advisable to do so, the Parties, in conjunction with the manner prescribed by Applicable Law. Each payment made Claims Administrator, shall submit a timely report to the Court summarizing the work performed by the Service Provider with respect to claims subject to this Agreement Claims Administrator. Without limiting the foregoing, the Claims Administrator shall, where appropriate, be made in full and final discharge of the obligations of the Company or the Service Provider under the applicable Reinsured Policy with respect to such payment;: (ba) Reviewing and (subject to Section 6.03 of this Agreement) compromising or denying, as is appropriate based on the guidelines of the Company in effect immediately prior promptly forward upon request to the Effective Date, GEICO COMPANIES’ Counsel and Class Counsel copies of all claims for benefits which the Service Provider's review determines to be qualified for such denial or compromise, in reliance on applicable Reinsured Policy provisions. In the event of non-payment of claims on account of incomplete or insufficient data, the Service Provider shall acknowledge such fact documents and other materials relating to the claimant by the earlier of (i) ten (10) Business Days from date of receipt of the claim or (ii) the number of days provided by Applicable Law; (c) Communicating with claimants with respect to the submission, approval and payment, compromise or denial of claims made under the Reinsured Policies; (d) Maintaining such files and records as are necessary to enable the Company, at any time, to determine the true and accurate claim experience on the Reinsured Policies; (e) Conforming to the reasonable requirements set by the Company for monthly submission of claims reports; (f) Performing such other claim services as may be reasonably required in connection with the support and administration of the Reinsured PoliciesSettlement Agreement; (gb) Preparing all Federal Tax receive Opt-Out Requests from Settlement Class Members and promptly provide to Class Counsel and the GEICO COMPANIES’ Counsel a copy thereof upon receipt. If the Claims Administrator receives any Opt-Out Requests from Settlement Class Members after the Opt-Out Deadline, the Claims Administrator shall promptly provide copies thereof to Class Counsel and the GEICO COMPANIES’ Counsel; c) provide reports and state tax reports required by Applicable Lawsummaries, as requested, to Class Counsel and the GEICO COMPANIES’ Counsel, including without limitation 1099-R, 1099-INT, 1099MISC, W-2P, W-2 reports regarding the number of Claim Forms received and 5498 the identity of the Settlement Class Members; d) employ reasonable procedures to screen Claims Forms for policyholders and beneficiaries as requiredfraud, and distributing shall reject a Claim Form, or any part of a claim for a payment reflected therein, where the same to policyholders Claims Administrator determines that there is evidence of fraud. The Claims Administrator will review each Claim Form based upon the initial submission by Settlement Class Members and beneficiaries and appropriate authoritiesensure that each is complete; e) prepare a declaration attesting to compliance with the Class Notice requirements set forth in this Agreement and identifying all Opt-Outs and/or objectors. The declaration shall be provided to the GEICO COMPANIES’ Counsel and Class Counsel for filing with the Court no later than fourteen (h14) Responding days prior to any requests from plan administrators or trustees for policy information affecting the plan or participants for qualified plansFairness Hearing; f) issue Settlement Benefit checks on Valid Claim Forms. Settlement Benefit checks issued pursuant to this Agreement shall bear in the legend that they expire if not negotiated within one hundred and eighty (i180) Responding days of their date of issue. To the extent that a Settlement Benefit check issued to requests for calculations applicable a Settlement Class Member is not cashed within one hundred and eighty (180) days after the date of issue, the check will be void and deemed unclaimed property. Accordingly, no uncashed Settlement Benefit checks will revert to annuity payments as may be necessary for Tax calculations; (j) Responding to requests for partial claims, including but not limited to waiver of premium riders, nursing home provisions, and waiver of monthly deductionthe GEICO COMPANIES; and (kg) Cooperation with Company efforts to facilitate fraud detection and investigation that may relate to both issue IRS 1099 forms as required by the Reinsured Policies and other business of the Company or its affiliates. (l) Administering payouts on annuity contracts, in the event of the death of the owner of the contract, in conformance with contract provisions and the applicable provisions of the Internal Revenue Code.

Claims Administration. The Service Provider shall administer claims on the Reinsured Policies as appropriate, including the following: (a) Reviewing and paying all claims for benefits which the Service Provider's review determines to be qualified for payment in accordance with applicable Reinsured Policy provisions. Any such payments shall be made within the time periods and in the manner prescribed by Applicable applicable Law. Each payment made by the Service Provider with respect to claims subject to this Agreement shall, where appropriate, be made in full and final discharge of the obligations of the Company or the Service Provider under the applicable Reinsured Policy with respect to such payment; (b) Reviewing and (subject to Section 6.03 of this Agreement) compromising or denying, as is appropriate based on the guidelines of the Company and CNL, Inc. in effect immediately prior to the Effective DateTime, all claims for benefits which the Service Provider's review determines to be qualified for such denial or compromise, in reliance on applicable Reinsured Policy provisions. In the event of non-non payment of claims on account of incomplete or insufficient data, the Service Provider shall acknowledge such fact to the claimant by the earlier of (i) ten (10) Business Days working days from date of receipt of the claim or (ii) the number of days provided by Applicable applicable Law; (c) Communicating with claimants with respect to the submission, approval and payment, compromise or denial of claims made under the Reinsured PoliciesPolicies administered under this Agreement; (d) Maintaining such files and records as are necessary to enable the Company, at any time, to determine the true and accurate claim experience on the Reinsured Policies. Said files and records on any Reinsured Policy are and shall remain the property of the Company; (e) Conforming to the reasonable requirements set by the Company for monthly submission of claims reports;; and (f) Performing such other claim services as may be reasonably required in connection with the support and administration of the Reinsured Policies;. (g) Preparing all required Federal Tax reports and state tax reports required by Applicable Lawreports, including without limitation 1099-R, 1099-INT, 1099MISC, W-2P, W-2 and 5498 for policyholders contract owners and beneficiaries as required, required and distributing the same to policyholders contract owners and beneficiaries and appropriate authorities; (h) Responding to any requests from plan administrators or trustees for policy information affecting the plan or participants for qualified plans; (i) Responding to requests for calculations applicable to annuity payments as may be necessary for Tax calculations; (j) Responding to requests for partial claims, including but not limited to waiver of premium riders, nursing home provisions, and waiver of monthly deduction; and (k) Cooperation with Company efforts to facilitate fraud detection and investigation that may relate to both the Reinsured Policies and other business of the Company or its affiliates. (l) Administering payouts on annuity contracts, in the event of the death of the owner of the contract, in conformance with contract provisions and the applicable provisions of the Code.

Claims Administration. The Service Provider shall administer claims on the Reinsured Policies Contracts as appropriate, including the following: (a) Reviewing and paying all claims for benefits which the Service Provider's review determines to be qualified for payment in accordance with applicable Reinsured Policy Contract provisions. Any such payments shall be made within the time periods and in the manner prescribed by Applicable Law. Each payment made by the Service Provider with respect to claims subject to this Agreement shall, where appropriate, be made in full and final discharge of the obligations of the Company FAFLIC or the Service Provider under the applicable Reinsured Policy Contract with respect to such payment; (b) Reviewing and (subject to Section 6.03 of this Agreement) compromising or denying, as is appropriate based on a level of accuracy and responsiveness not less favorable than the guidelines practices of the Company Service Provider in effect immediately prior to the Effective Dateadministering its own products, all claims for benefits which the Service Provider's review determines to be qualified for such denial or compromise, in reliance on applicable Reinsured Policy provisionsContract provisions and Applicable Law. In the event of non-payment of claims on account of incomplete or insufficient data, the Service Provider shall acknowledge such fact to the claimant by the earlier of (iof(i) ten (10) Business Days from date of receipt of the claim or (ii) the number of days provided by Applicable Law; (c) Communicating with claimants with respect to the submission, approval and payment, compromise or denial of claims made under the Reinsured PoliciesContracts; (d) Maintaining such files and records as are necessary to enable the CompanyFAFLIC, at any time, to reasonably determine the true and accurate claim experience on the Reinsured PoliciesContracts; (e) Conforming to the reasonable requirements set by the Company FAFLIC for monthly submission of claims reports, but only the extent such reports were produced by FAFLIC prior to the Closing Date; (f) Performing such other claim services as may be reasonably required in connection with the support and administration of the Reinsured PoliciesContracts; (g) Preparing all Federal Tax reports and state tax reports required by Applicable Law, including including, without limitation limitation, 1099-R, 1099-INT, 1099MISC1O99MISC, W-2P, W-2 and 5498 for policyholders and beneficiaries as A-3 required, and distributing the same to policyholders and beneficiaries and appropriate authorities; (h) Responding to any requests from plan administrators or trustees for policy information affecting the plan or participants for qualified plans; (i) Responding to reasonable requests for calculations applicable to annuity payments as may be necessary for Tax calculations; (j) Responding to reasonable requests for partial claims, including but not limited including, without limitation, with respect to waiver of premium riders, nursing home provisions, and waiver of monthly deduction; and (k) Cooperation Reasonable cooperation with Company FAFLIC efforts to facilitate fraud detection and investigation that may relate to both the Reinsured Policies and other business of the Company or its affiliatesContracts. (l1) Administering payouts on annuity contracts, contracts in the event of the death of the owner of the contract, in conformance conformity with contract provisions and the applicable provisions of the Code.

Claims Administration. The Service Provider shall administer claims Commencing on the Reinsured Policies Effective Date, TMG hereby authorizes HPS to administer, and HPS hereby agrees to administer, any and all claims arising under the Administered Business regardless of when such claims are incurred (collectively, "Claims"). Without limiting the generality of the previous sentence, as appropriateTMG's representative, including the followingHPS shall: (a) Reviewing 1. Diligently adjust and paying settle all claims for benefits which the Service Provider's review determines to be qualified for payment Claims in accordance with applicable Reinsured Policy provisionsLaw and the Guidelines. 2. Any Receive and process the Claims in accordance with applicable Law and the Guidelines. 3. Examine each Claim and determine whether a claimant asserting a Claim ("Claimant") is entitled to compensation under applicable Law and the Guidelines and, if a Claimant is so entitled to compensation, arrange for the prompt payment of such payments Claim from the Claims Account (as defined in Section I(6)) provided, however, that HPS shall be made not pay, without the prior written approval of TMG, any Claims paid or incurred on any insured within the time periods and previous twelve months in the manner prescribed by Applicable Law. Each payment made by the Service Provider with respect to claims subject to this Agreement shall, where appropriate, be made in full and final discharge excess of the obligations of the Company or the Service Provider under the applicable Reinsured Policy with respect to such payment; (b) Reviewing and (subject to Section 6.03 of this Agreement) compromising or denying, as is appropriate based on the guidelines of the Company in effect immediately prior to the Effective Date, all claims for benefits which the Service Provider's review determines to be qualified for such denial or compromise, in reliance on applicable Reinsured Policy provisions. In the event of non-payment of claims on account of incomplete or insufficient data, the Service Provider shall acknowledge such fact to the claimant by the earlier lesser of (i) ten (10) Business Days from date of receipt of the claim $100,000 or (ii) one percent of TMG's policyholder surplus as set forth in its most recent annual statutory financial statement, about which TMG shall notify HPS on or before April 1st of each year in which this Agreement is in effective. 4. Pay all allocated loss adjustment expenses related to any Claim from the number Claims Account ("Allocated Loss Adjustment Expenses") which shall include all fees, costs and expenses related to independent adjusters and investigators, experts, witnesses, attorneys, taxes, court costs, settlements, judgments, post-judgment interest, and other reasonable and necessary fees, costs and expenses incurred in connection with the investigation, defense and settlement of days Claims, but not HPS's salaries, benefits, administrative costs, normal overhead, or other internal costs or expenses. 5. Promptly notify each Claimant if his Claim has been denied in whole or in part, and the reasons for such denial. 6. Investigate any Claims that are not supported by sufficient factual documentation. 7. Settle any disputes concerning a Claim on reasonable terms and conditions, in accordance with the Guidelines, or as directed in writing by TMG provided, however, that (i) HPS shall not settle any disputed Claim for more than $100,000 without the prior approval of TMG and (ii) HPS shall obtain from the Claimant an unconditional release of TMG, TMG's reinsurers and their respective affiliates in respect of the disputed Claim. 8. Make such calculations as shall enable TMG and/or CGLIC to establish loss reserves for each Claim in accordance with instructions provided by Applicable Law;CGLIC and TMG on or before the third business day of each month for the prior month (provided, that if, for reasons beyond the control of and not the fault of HPS, such calculations cannot be made as of such date, HPS shall provide to TMG reasonable estimates of such calculations on such date and shall provide to TMG the actual calculations as soon as is practical), revise such reserves as circumstances warrant, and notify TMG of the amount of the reserves, but HPS shall have no liability for the under or overestimation of such reserves provided that such under or overestimation was not caused by HPS's negligence. (c) Communicating with claimants with 9. Analyze all Claims to determine whether TMG and/or CGLIC, as the case may be, is entitled to any right of subrogation in respect of such Claim, and make reasonable efforts to the submissionenforce such subrogation rights on behalf of TMG. 10. Retain any professional or other third party services previously approved of by TMG in writing, approval and payment, compromise or denial of claims made under the Reinsured Policies; (d) Maintaining such files and records as are necessary to enable the Company, at any timewhich shall not be unreasonably withheld, to determine assist in the true and accurate claim experience on the Reinsured Policies; (e) Conforming to the reasonable requirements set by the Company for monthly submission adjustment of claims reports; (f) Performing such other claim services any Claims as may be reasonably required appropriate in connection accordance with the support Guidelines. 11. Assist (in particular, provide Claims file information and administration supporting documents) TMG in TMG's litigation or arbitration of any disputed Claim that cannot be settled on a reasonable basis. 12. Report all Claims to TMG in a timely manner in accordance with the Reinsured Policies; (g) Preparing all Federal Tax reports and state tax reports required by Applicable Law, including without limitation 1099-R, 1099-INT, 1099MISC, W-2P, W-2 and 5498 for policyholders and beneficiaries pursuant to Section I(F)(5). 13. Send to TMG a copy of any Claim file that TMG may request or as required, and distributing soon as it becomes known that the same to policyholders and beneficiaries and appropriate authorities; (h) Responding to any requests from plan administrators or trustees for policy information affecting the plan or participants for qualified plans; Claim (i) Responding has the potential to requests for calculations applicable exceed an amount equal to annuity payments as may be necessary for Tax calculations; (j) Responding to requests for partial claims, including but not limited to waiver of premium riders, nursing home provisions, and waiver of monthly deduction; and (k) Cooperation with Company efforts to facilitate fraud detection and investigation that may relate to both the Reinsured Policies and other business lesser of the Company amount set forth in Section I(C)(3) or its affiliates. an amount established by any relevant Governmental Entity; (lii) Administering payouts on annuity contractsinvolves a coverage dispute; (iii) exceed HPS's Claims settlement authority set forth in Section I(C)(7); (iv) is open for more than six months; or (v) is closed by payment of an amount greater than the lesser of the amount set forth in Section I(C)(7) or an amount set by any relevant Governmental Entity. All Claim files will be the joint property of TMG and HPS; provided, however, that in the event an order of liquidation is entered against TMG, such files shall become the death sole property of the owner of the contractTMG or its estate, in conformance with contract provisions which case HPS shall have reasonable access to and the applicable provisions of the Coderight to copy such files on a timely basis.

Claims Administration. The Service Provider shall administer claims on the Reinsured Policies as appropriate, including the following: (a) Reviewing On and paying all claims for benefits which after the Service Provider's review determines to be qualified for payment in accordance with applicable Reinsured Policy provisions. Any such payments shall be made within the time periods and in the manner prescribed by Applicable Law. Each payment made by the Service Provider with respect to claims subject to this Agreement shall, where appropriate, be made in full and final discharge of the obligations of the Company or the Service Provider under the applicable Reinsured Policy with respect to such payment; (b) Reviewing and (subject to Section 6.03 of this Agreement) compromising or denying, as is appropriate based on the guidelines of the Company in effect immediately prior to the Assumption Effective Date, all claims for benefits which the Service Provider's review determines to be qualified for such denial or compromise, in reliance on applicable Reinsured Policy provisions. In the event of non-payment of claims on account of incomplete or insufficient data, the Service Provider shall acknowledge such fact to the claimant by the earlier of (i) ten (10) Business Days from date of receipt of the claim or (ii) the number of days provided by Applicable Law; (c) Communicating with claimants with respect to the submission, approval and payment, compromise or denial of claims made under the Reinsured Policies; (d) Maintaining such files and records as are necessary to enable the Company, at any time, to determine the true and accurate claim experience on the Reinsured Policies; (e) Conforming to the reasonable requirements set by the Company will provide prompt notice to HCPCI or its designee of all Claims for monthly submission of claims reports; (f) Performing such other claim services as Post-Assumption Losses which may be reasonably required in connection with the support and administration of the Reinsured Policies; (g) Preparing all Federal Tax reports and state tax reports required received by Applicable Law, including without limitation 1099-R, 1099-INT, 1099MISC, W-2P, W-2 and 5498 for policyholders and beneficiaries as required, and distributing the same to policyholders and beneficiaries and appropriate authorities; (h) Responding to any requests from plan administrators or trustees for policy information affecting the plan or participants for qualified plans; (i) Responding to requests for calculations applicable to annuity payments as may be necessary for Tax calculations; (j) Responding to requests for partial claims, including but not limited to waiver of premium riders, nursing home provisions, and waiver of monthly deduction; and (k) Cooperation with Company efforts to facilitate fraud detection and investigation that may relate to both the Reinsured Policies and other business on behalf of the Company or its affiliatesAffiliates (but only to the extent such Claims are not otherwise known or reported to HCPCI or any of its Affiliates), and HCPCI or its designee will have the obligation to administer, investigate and defend, as applicable, at its own expense, any Claim for Post Assumption Losses. HCPCI shall have no duty, responsibility or obligation to administer any Claims occurring prior to the Assumption Effective Date or arising from or in any way associated with an event occurring before the Assumption Effective Date. At the request of HCPCI or such designee, the Company will jointly associate with HCPCI, at the expense of HCPCI, in the defense or control of any Claim, suit or proceeding involving the Assumed Policies, and the Company shall reasonably cooperate with HCPCI or such designee, at the expense of HCPCI, in every respect to procure the most favorable disposition of such claim, suit or proceeding. (lb) Administering payouts The Company grants to HCPCI or one or more of HCPCI’s Affiliates designated by HCPCI, as of the Assumption Effective Date, authority in all matters relating to the administration of the Assumed Policies and any Claims for Post-Assumption Losses covered by this Agreement, including the authority (i) to pay and adjust Claims for Post-Assumption Losses which may be received by or on annuity behalf of the Company, and (ii) to communicate directly with policyholders and to collect on behalf of the Company unpaid Premiums attributed solely to the Assumed Policies on and after the Assumption Effective Date. In exercising such authorities, HCPCI or any such Affiliate may delegate the performance of any duty described above to a third party; provided that no such delegation shall relieve HCPCI of its obligations hereunder. Subject to the forgoing limitation, effective as of the Assumption Effective Date, the Company hereby appoints HCPCI as its attorney-in-fact with respect to the rights, duties and privileges and obligations of the Company in and to the Assumed Policies, with full power and authority to act in the name, place and stead of the Company with respect to such contracts, including without limitation, the power to service such contracts, to adjust, defend, settle and to pay all Claims for Post-Assumption Losses, to recover salvage and subrogation for any Post-Assumption Losses incurred and to take such other and further actions as may be necessary or desirable to effect the transactions contemplated by this Agreement. As part of the foregoing, the Company grants full authority to HCPCI to adjust, settle or compromise all Post-Assumption Losses hereunder, and all such adjustments, settlements and compromises shall be binding on the Company. The Company agrees, at HCPCI’s expense, to cooperate fully with HCPCI in the event transfer of such administration, and HCPCI agrees to be responsible for such administration. (c) HCPCI shall maintain sufficient resources and adequate staffing levels of personnel with appropriate experience to administer Claims for Post-Assumption Losses under the death of the owner of the contract, Assumed Policies in conformance a professional manner in accordance with contract provisions and the applicable provisions of the Codeall Applicable Laws.

Claims Administration. The Service Provider Administrator shall administer claims on the Reinsured Policies as appropriate, including the following: (a) Reviewing and paying all claims for benefits which the Service ProviderAdministrator's review determines to be qualified for payment in accordance with applicable Reinsured Policy provisions. Any such payments shall be made within the time periods and in the manner prescribed by Applicable Lawapplicable law. Each payment made by the Service Provider Administrator with respect to claims subject to this Agreement shall, where appropriate, be made in full and final discharge of the obligations of the Company Seller or the Service Provider Administrator under the applicable Reinsured Policy with respect to such payment; (b) Reviewing and (subject to Section 6.03 of this Agreement) compromising or denying, as is appropriate based on the guidelines of the Company Seller in effect immediately prior to the Effective Date, all claims for benefits which the Service ProviderAdministrator's review determines to be qualified for such denial or compromise, in reliance on applicable Reinsured Policy provisions. In the event of non-non- payment of claims on account of incomplete or insufficient data, the Service Provider Administrator shall acknowledge such fact to the claimant by the earlier of (i) ten (10) Business Days working days from date of receipt of the claim or (ii) the number of days provided by Applicable Lawapplicable law; (c) Communicating with claimants with respect to the submission, approval and payment, compromise or denial of claims made under the Reinsured PoliciesPolicies administered under this Agreement; (d) Maintaining such files and records as are necessary to enable the CompanySeller, at any time, to determine the true and accurate claim experience on the Reinsured Policies. Said files and records on any Reinsured Policy are and shall remain the property of the Seller; (e) Conforming to the reasonable requirements set by the Company Seller for monthly submission of claims reports; (f) Performing such other claim services as may be reasonably required in connection with the support and administration of the Reinsured Policies; (g) Preparing all required Federal Tax reports and state tax reports required by Applicable Lawreports, including without limitation 1099-R, 1099-INT, 1099MISC, W-2P, W-2 and 5498 for policyholders contract owners and beneficiaries as required, required and distributing the same to policyholders contract owners and beneficiaries and appropriate authorities; (h) Responding to any requests from plan administrators or trustees for policy information affecting the plan or participants for qualified plans; (i) Responding to requests for calculations applicable to annuity payments as may be necessary for Tax calculations; (j) Responding to requests for partial claims, including but not limited to waiver of premium riders, nursing home provisions, and waiver of monthly deduction; and (k) Cooperation with Company efforts to facilitate fraud detection and investigation that may relate to both the Reinsured Policies and other business of the Company or its affiliates. (l) Administering payouts on annuity contracts, in the event of the death of the owner of the contract, in conformance with contract provisions and the applicable provisions of the Code.

Claims Administration. The Service Provider shall administer claims on the Reinsured Policies as appropriate, including the following: (a) Reviewing and paying all claims for benefits which the Service Provider's review determines to be qualified for payment in accordance with applicable Reinsured Policy provisions. Any such payments shall be made within the time periods and in the manner prescribed by Applicable Law. Each payment made by the Service Provider with respect to claims subject to this Agreement shall, where appropriate, be made in full and final discharge of the obligations of While the Company or the Service Provider under the applicable Reinsured Policy with respect will retain Claim Authority pursuant to such payment; (b) Reviewing and (subject to Section 6.03 of this Agreement) compromising or denying, as is appropriate based on the guidelines of the Company in effect immediately prior to the Effective Date, all claims for benefits which the Service Provider's review determines to be qualified for such denial or compromise, in reliance on applicable Reinsured Policy provisions. In the event of non-payment of claims on account of incomplete or insufficient dataArticle 17, the Service Provider shall acknowledge such fact Parties desire to the claimant by the earlier of (i) ten (10) Business Days from date of receipt of the claim or (ii) the number of days provided by Applicable Law; (c) Communicating with claimants work together with respect to the submissionadministration of the Subject Business. The Reinsured Group shall give the Reinsurer, approval and paymentor its wholly-owned subsidiaries or affiliates, compromise the right of first refusal (“ROFR”) on any material third-party claims administration services relating to the Subject Business that it outsources during the term of this Agreement, other than (i) claims administration services performed by third parties as of Xxxxx 00, 0000, (xx) claims administration services that an Insured or denial of claims made other third party is contractually entitled to perform under the terms of a Policy or other agreement with the Reinsured Group, and (iii) consulting or advisory services procured from third parties with specialized expertise; provided that the Reinsurer shall have demonstrated to the reasonable satisfaction of the Company that the Reinsurer, or the applicable subsidiary, affiliate, agent or contractor proposed by the Reinsurer to perform such claims administration services, has the skill, resources and knowledge required to provide the applicable claims administration services in accordance with the terms of the applicable Policies; , in compliance with applicable law, and at a level of performance no lower than the service standards historically applied by the Reinsured Group in performing such services for its own account (dthe “Assumption Conditions”); provided, further, that the Reinsurer shall not engage any unaffiliated third party to perform such claims administration services without the prior written consent of the Company (such consent not to be unreasonably withheld, conditioned or delayed). The Company shall pay to the Reinsurer a claims administration monitoring fee of $1,000,000 annually, first payable on July 15, 2017 and on each July 15 thereafter, but in no event for more than thirty (30) Maintaining such files and records as are necessary annual payments. The Company’s obligation to enable pay such claims administration monitoring fee shall terminate upon the first to occur of (x) payment of the thirtieth (30th) such annual payment by the Company, at any time, to determine (y) the true and accurate claim experience date on which the Reinsured Policies; Reinsurer (eon its own behalf or through its designated agent or contractor) Conforming assumes claims handling services with respect to the reasonable requirements set by Covered Business (pursuant to Article 13 or otherwise) and (z) the Company for monthly submission date that the Reinsurer has paid an aggregate net amount in respect of claims reports; (f) Performing such other claim services as may be reasonably required in connection with Ultimate Net Loss equal to the support and administration of the Reinsured Policies; (g) Preparing all Federal Tax reports and state tax reports required by Applicable Law, including without limitation 1099-R, 1099-INT, 1099MISC, W-2P, W-2 and 5498 for policyholders and beneficiaries as required, and distributing the same to policyholders and beneficiaries and appropriate authorities; (h) Responding to any requests from plan administrators or trustees for policy information affecting the plan or participants for qualified plans; (i) Responding to requests for calculations applicable to annuity payments as may be necessary for Tax calculations; (j) Responding to requests for partial claims, including but not limited to waiver of premium riders, nursing home provisions, and waiver of monthly deduction; and (k) Cooperation with Company efforts to facilitate fraud detection and investigation that may relate to both the Reinsured Policies and other business of the Company or its affiliatesLimit. (l) Administering payouts on annuity contracts, in the event of the death of the owner of the contract, in conformance with contract provisions and the applicable provisions of the Code.

Claims Administration. The Service Provider claims administration obligations of Administrator shall administer include the review of all claims on and potential claims, and creation and maintenance of files with respect to, and administration to final disposition and payment of, each claim arising out of or related to the Reinsured New York Insurance Policies as appropriateor the New York Insurance Liabilities, including made to or received by New York Ceding Company or Administrator, and all such other acts and things reasonably necessary in the administration and settlement of a claim with respect to a New York Insurance Policy or a New York Insurance Liability. In connection with the foregoing, the claims administration obligations of Administrator shall also include, but not be limited to, the following: (a) Reviewing The provision of standard forms and paying all claims documents necessary for benefits which the Service Provider's review determines to be qualified for payment in accordance with applicable Reinsured Policy provisions. Any such payments shall be made submission and processing of claims; b) Acknowledgement, within the time periods and in the manner prescribed by Applicable Law. Each payment made by the Service Provider with respect to claims subject to this Agreement shall, where appropriate, be made in full and final discharge of the obligations of the Company or the Service Provider under the applicable Reinsured Policy with respect to such payment; (b) Reviewing and (subject to Section 6.03 of this Agreement) compromising or denying, as is appropriate based on the guidelines of the Company in effect immediately prior to the Effective Date, all claims for benefits which the Service Provider's review determines to be qualified for such denial or compromise, in reliance on applicable Reinsured Policy provisions. In the event of non-payment of claims on account of incomplete or insufficient data, the Service Provider shall acknowledge such fact to the claimant by the earlier lesser of (i) ten the period required by Applicable Law or (10ii) forty-eight (48) hours, to the appropriate party of the receipt of notices received from claimants or obligees in connection with any claim; c) Prompt investigation of any claim, as necessary, to determine its validity and compensability, including verification of coverage and status, and utilization of any relevant documents or other information made available to Administrator; d) Claim decisions shall be communicated to claimant, obligee or other appropriate person within the lesser of (i) the time permitted by Applicable Law or (ii) fifteen (15) Business Days of all requirements being received by Administrator; e) Administrator shall consult with New York Ceding Company prior to denying any claim. If New York Ceding Company determines in its sole discretion that the claim should be approved and paid, Administrator shall pay the claim; f) Administration of coordination of benefits provisions of the New York Insurance Policies, if applicable; g) Performance of all administrative and clerical work in connection with any claim, including computation and verification of the amount of benefits; h) When a claimant has furnished an appropriate authorization required by law, furnishing to the appropriate party copies of benefit statements prepared for claimants; i) Reasonably responding to any inquiry, complaint or request, received from date any claimant, agent, broker, insurance regulatory authority or other interested party pertaining to or regarding any such claim, and proper recording of such complaints in separate complaint logs to be maintained by Administrator. Administrator shall provide to New York Ceding Company, within two (2) Business Days of Administrator’s receipt thereof, notice and copies (if such complaints are received in writing) of all complaints or inquiries sent by attorneys on behalf of policyholders and insurance regulatory authorities (whether or not such are on behalf of policyholders). Administrator shall provide to New York Ceding Company, on a monthly basis, notice and copies (if complaints are received in writing) of all other customer and policyholder complaints received by Administrator since the preparation of the previous such report. New York Ceding Company shall be consulted with prior to the resolution of any such inquiry, complaint or request which reasonably could result in litigation or a fine or sanction imposed by an insurance regulatory authority. New York Ceding Company shall have final authority over the resolution of any inquiry, complaint or request pertaining to or regarding any claim. New York Ceding Company shall have the right to inspect Administrator’s complaint log during regular business hours upon three (3) calendar days’ prior notice; j) Provision of standard telephone arrangements, including access to toll-free telephone lines, in order to provide the Administrative Services; k) Within the lesser of (i) thirty (30) calendar days of receipt of the claim submitted bills or (ii) the number period provided for by Applicable Law, the payment of days provided by benefits, unless otherwise declined in accordance with the terms of the applicable New York Insurance Policy and Applicable Law; (cl) Communicating with claimants with respect to To the submission, approval and payment, compromise or denial of claims made under the Reinsured Policies; (d) Maintaining such files and records as are necessary to enable the Company, at any time, to determine the true and accurate claim experience on the Reinsured Policies; (e) Conforming to the reasonable requirements set by the Company for monthly submission of claims reports; (f) Performing such other claim services as may be reasonably required in connection with the support and administration of the Reinsured Policies; (g) Preparing all Federal Tax reports and state tax reports extent required by Applicable Law, including without limitation 1099-R, 1099-INT, 1099MISC, W-2P, W-2 the preparation of individual income tax reports indicating the benefits paid and 5498 for policyholders and beneficiaries as requiredany amounts withheld, and distributing delivery of such reports to the same to policyholders and beneficiaries and appropriate authoritiesparties; (hm) Responding to any requests from plan administrators or trustees for policy information affecting the plan or participants for qualified plansCompliance with all applicable regulatory and industry standards regarding claims handling and claims file maintenance, record retention and reconciliation requirements. Compliance with all state-mandated reporting of information; (in) Responding Engagement and direction, as necessary, of attorneys, consultants and other professionals in connection with the processing and handling of any claim; provided, however, that New York Ceding Company retains the right to requests for calculations applicable object to annuity payments as may be necessary for Tax calculations; (j) Responding to requests for partial claims, including but not limited to waiver the engagement of premium riders, nursing home provisions, and waiver an attorney hereunder where a conflict of monthly deductioninterest exists; and (ko) Cooperation with Company efforts to facilitate fraud detection Generally, all such other acts and investigation that may relate to both the Reinsured Policies and other business of the Company or its affiliates. (l) Administering payouts on annuity contracts, things necessary in the event administration and settlement of the death all claims, and all other acts and services consistent with that of the owner of the contract, in conformance with contract provisions and the applicable provisions of the Codereputable insurance companies.

Claims Administration. The Service Provider claims administration obligations of Administrator shall administer include the review of all claims on and potential claims, and creation and maintenance of files with respect to, and administration to final disposition and payment of, each claim arising out of or related to the Reinsured New York Insurance Policies as appropriateor the New York Insurance Liabilities, including made to or received by New York Ceding Company or Administrator, and all such other acts and things reasonably necessary in the administration and settlement of a claim with respect to a New York Insurance Policy or a New York Insurance Liability. In connection with the foregoing, the claims administration obligations of Administrator shall also include, but not be limited to, the following: (a) Reviewing The provision of standard forms and paying all claims documents necessary for benefits which the Service Provider's review determines to be qualified for payment in accordance with applicable Reinsured Policy provisions. Any such payments shall be made submission and processing of claims; b) Acknowledgement, within the time periods and in the manner prescribed by Applicable Law. Each payment made by the Service Provider with respect to claims subject to this Agreement shall, where appropriate, be made in full and final discharge of the obligations of the Company or the Service Provider under the applicable Reinsured Policy with respect to such payment; (b) Reviewing and (subject to Section 6.03 of this Agreement) compromising or denying, as is appropriate based on the guidelines of the Company in effect immediately prior to the Effective Date, all claims for benefits which the Service Provider's review determines to be qualified for such denial or compromise, in reliance on applicable Reinsured Policy provisions. In the event of non-payment of claims on account of incomplete or insufficient data, the Service Provider shall acknowledge such fact to the claimant by the earlier lesser of (i) ten the period required by Applicable Law or (10ii) forty-eight (48) hours, to the appropriate party of the receipt of notices received from claimants or obligees in connection with any claim; c) Prompt investigation of any claim, as necessary, to determine its validity and compensability, including verification of coverage and status, and utilization of any relevant documents or other information made available to Administrator; d) Claim decisions shall be communicated to claimant, obligee or other appropriate person within the lesser of (i) the time permitted by Applicable Law or (ii) fifteen (15) Business Days of all requirements being received by Administrator; e) Administrator shall consult with New York Ceding Company prior to denying any claim. If New York Ceding Company determines in its sole discretion that the claim should be approved and paid, Administrator shall pay the claim; f) Administration of coordination of benefits provisions of the New York Insurance Policies, if applicable; g) Performance of all administrative and clerical work in connection with any claim, including computation and verification of the amount of benefits; h) When a claimant has furnished an appropriate authorization required by law, furnishing to the appropriate party copies of benefit statements prepared for claimants; i) Reasonably responding to any inquiry, complaint or request, received from date any claimant, agent, broker, insurance regulatory authority or other interested party pertaining to or regarding any such claim, and proper recording of such complaints in separate complaint logs to be maintained by Administrator. Administrator shall provide to New York Ceding Company, within two (2) Business Days of Administrator’s receipt thereof, notice and copies (if such complaints are received in writing) of all complaints or inquiries sent by attorneys on behalf of policyholders and insurance regulatory authorities A - 4 (whether or not such are on behalf of policyholders). Administrator shall provide to New York Ceding Company, on a monthly basis, notice and copies (if complaints are received in writing) of all other customer and policyholder complaints received by Administrator since the preparation of the previous such report. New York Ceding Company shall be consulted with prior to the resolution of any such inquiry, complaint or request which reasonably could result in litigation or a fine or sanction imposed by an insurance regulatory authority. New York Ceding Company shall have final authority over the resolution of any inquiry, complaint or request pertaining to or regarding any claim. New York Ceding Company shall have the right to inspect Administrator’s complaint log during regular business hours upon three (3) calendar days’ prior notice; j) Provision of standard telephone arrangements, including access to toll-free telephone lines, in order to provide the Administrative Services; k) Within the lesser of (i) thirty (30) calendar days of receipt of the claim submitted bills or (ii) the number period provided for by Applicable Law, the payment of days provided by benefits, unless otherwise declined in accordance with the terms of the applicable New York Insurance Policy and Applicable Law; (cl) Communicating with claimants with respect to To the submission, approval and payment, compromise or denial of claims made under the Reinsured Policies; (d) Maintaining such files and records as are necessary to enable the Company, at any time, to determine the true and accurate claim experience on the Reinsured Policies; (e) Conforming to the reasonable requirements set by the Company for monthly submission of claims reports; (f) Performing such other claim services as may be reasonably required in connection with the support and administration of the Reinsured Policies; (g) Preparing all Federal Tax reports and state tax reports extent required by Applicable Law, including without limitation 1099-R, 1099-INT, 1099MISC, W-2P, W-2 the preparation of individual income tax reports indicating the benefits paid and 5498 for policyholders and beneficiaries as requiredany amounts withheld, and distributing delivery of such reports to the same to policyholders and beneficiaries and appropriate authoritiesparties; (hm) Responding to any requests from plan administrators or trustees for policy information affecting the plan or participants for qualified plansCompliance with all applicable regulatory and industry standards regarding claims handling and claims file maintenance, record retention and reconciliation requirements. Compliance with all state-mandated reporting of information; (in) Responding Engagement and direction, as necessary, of attorneys, consultants and other professionals in connection with the processing and handling of any claim; provided, however, that New York Ceding Company retains the right to requests for calculations applicable object to annuity payments as may be necessary for Tax calculations; (j) Responding to requests for partial claims, including but not limited to waiver the engagement of premium riders, nursing home provisions, and waiver an attorney hereunder where a conflict of monthly deductioninterest exists; and (ko) Cooperation with Company efforts to facilitate fraud detection Generally, all such other acts and investigation that may relate to both the Reinsured Policies and other business of the Company or its affiliates. (l) Administering payouts on annuity contracts, things necessary in the event administration and settlement of the death all claims, and all other acts and services consistent with that of the owner of the contract, in conformance with contract provisions and the applicable provisions of the Codereputable insurance companies.

Claims Administration. The Service Provider claims administration obligations of Administrator shall administer include the review of all claims on the Reinsured Policies as appropriateand potential claims, including the following:and creation and maintenance of files (a) Reviewing The provision of standard forms and paying all claims documents necessary for benefits which the Service Provider's review determines to be qualified for payment in accordance with applicable Reinsured Policy provisions. Any such payments shall be made submission and processing of claims; b) Acknowledgement, within the time periods and in the manner prescribed by Applicable Law. Each payment made by the Service Provider with respect to claims subject to this Agreement shall, where appropriate, be made in full and final discharge of the obligations of the Company or the Service Provider under the applicable Reinsured Policy with respect to such payment; (b) Reviewing and (subject to Section 6.03 of this Agreement) compromising or denying, as is appropriate based on the guidelines of the Company in effect immediately prior to the Effective Date, all claims for benefits which the Service Provider's review determines to be qualified for such denial or compromise, in reliance on applicable Reinsured Policy provisions. In the event of non-payment of claims on account of incomplete or insufficient data, the Service Provider shall acknowledge such fact to the claimant by the earlier lesser of (i) ten (10) Business Days from date of receipt of the claim period required by Applicable Law or (ii) forty-eight (48) hours, to the number appropriate party of days provided by Applicable Lawthe receipt of notices received from claimants or obligees in connection with any claim; (c) Communicating with claimants with respect to the submissionPrompt investigation of any claim, approval and payment, compromise or denial of claims made under the Reinsured Policies; (d) Maintaining such files and records as are necessary to enable the Company, at any timenecessary, to determine the true its validity and accurate claim experience on the Reinsured Policiescompensability, including verification of coverage and status, and utilization of any relevant documents or other information made available to Administrator; (ed) Conforming Claim decisions shall be communicated to claimant, obligee or other appropriate person within the reasonable requirements set by the Company for monthly submission lesser of claims reports; (f) Performing such other claim services as may be reasonably required in connection with the support and administration of the Reinsured Policies; (g) Preparing all Federal Tax reports and state tax reports required by Applicable Law, including without limitation 1099-R, 1099-INT, 1099MISC, W-2P, W-2 and 5498 for policyholders and beneficiaries as required, and distributing the same to policyholders and beneficiaries and appropriate authorities; (h) Responding to any requests from plan administrators or trustees for policy information affecting the plan or participants for qualified plans; (i) Responding to requests for calculations applicable to annuity payments as may be necessary for Tax calculationsthe time permitted by Applicable Law or (ii) fifteen (15) Business Days of all requirements being received by Administrator; e) Administrator shall consult with Ceding Company prior to denying any claim. If Ceding Company determines in its sole discretion that the claim should be approved and paid, Administrator shall pay the claim and Ceding Company and Reinsurer shall share the financial responsibility of such claim seventy-five percent (j75%) Responding Ceding Company and twenty-five percent (25%) Reinsurer. Following payment thereof, either Ceding Company or Reinsurer may submit the claim to requests arbitration pursuant to Section 10.1 of the Reinsurance Agreement to seek reimbursement from the other Party for partial claimsits share of the claim. Notwithstanding anything in Section 10.1 of the Reinsurance Agreement to the contrary, the prevailing Party in any arbitration instituted pursuant to this provision shall be entitled to recover, unless the court of arbitration determines otherwise, one hundred percent (100%) of its costs incurred in connection therewith, including but not limited to waiver the prevailing Party’s attorneys’ fees and any portion of premium ridersthe arbitrator’s fees borne by the prevailing Party; f) Administration of coordination of benefits provisions of the Insurance Policies, nursing home provisionsif applicable; g) Performance of all administrative and clerical work in connection with any claim, including computation and verification of the amount of benefits; h) When a claimant has furnished an appropriate authorization required by law, furnishing to the appropriate party copies of benefit statements prepared for claimants; i) Reasonably responding to any inquiry, complaint or request, received from any claimant, agent, broker, insurance regulatory authority or other interested party pertaining to or regarding any such claim, and waiver proper recording of monthly deductionsuch complaints in separate complaint j) Provision of standard telephone arrangements, including access to toll-free telephone lines, in order to provide the Administrative Services; k) Within the lesser of (i) thirty (30) calendar days of receipt of submitted bills or (ii) the period provided for by Applicable Law, the payment of benefits, unless otherwise declined in accordance with the terms of the applicable Insurance Policy and Applicable Law; l) To the extent required by Applicable Law, the preparation of individual income tax reports indicating the benefits paid and any amounts withheld, and delivery of such reports to the appropriate parties; m) Compliance with all applicable regulatory and industry standards regarding claims handling and claims file maintenance, record retention and reconciliation requirements. Compliance with all state-mandated reporting of information; n) Engagement and direction, as necessary, of attorneys, consultants and other professionals in connection with the processing and handling of any claim; provided, however, that Ceding Company retains the right to object to the engagement of an attorney hereunder where a conflict of interest exists; and (ko) Cooperation with Company efforts to facilitate fraud detection Generally, all such other acts and investigation that may relate to both the Reinsured Policies and other business of the Company or its affiliates. (l) Administering payouts on annuity contracts, things necessary in the event administration and settlement of the death all claims, and all other acts and services consistent with that of the owner of the contract, in conformance with contract provisions and the applicable provisions of the Codereputable insurance companies.