Claims in Process. Upon termination of this Contract for any reason other than the Company’s breach, the Company shall continue to be authorized to provide recovery and auditing services with respect to all Claims in process on the termination date. Claims are considered in process if the Company or its third party vendor has evaluated, screened, audited or in any way processed it, including all Claims inventoried in Company’s claim payment database.
Claims in Process. Any claims made against insurers under the ---------------- Policies prior to the Distribution Date and unpaid as of such date shall be for the account of the party (i) whose asset after the Distribution Date is the basis for the claim, or (ii) in the case of a liability claim, which is the owner after the Distribution Date of the facility at which the activity which is the subject of the claim occurred or is alleged to have occurred. If the proceeds of the claim are received by a party other than the party entitled to receive such proceeds pursuant to this Section 1.01, such receiving party shall pay over such proceeds to such other party. In respect of claims under Policies for the account of LifePoint or Triad, in the event that any deductible, co- insurance or self-insured retention in respect of such claim has not been paid or accounted for prior to the Distribution Date, or if the Policy under which the claim was made provides for any aggregate deductible, co-insurance or self- insured retention or if the claim is not fully covered because the aggregate policy limits have been exhausted, such amounts shall be paid to such party by Columbia/HCA pursuant to the indemnification provided for in the Distribution Agreement.
Claims in Process. Any claims made against insurers under the ----------------- Documents prior to the Distribution Date and unpaid as of such date shall be for the account of the party whose asset after the Distribution Date is the basis for the claim. For the purposes of this Agreement, a Leased Facility shall be deemed to be a New Hillhaven asset, and with regard to such Leased Facilities, New Hillhaven shall be deemed to be "the party whose asset is the basis of the claim." If the Proceeds of the claim are received by a party other than the party entitled to receive such proceeds pursuant to this Section 1.01, such receiving party shall pay over such proceeds to such other party. In the event that any deductible, co-insurance or self-insured retention in respect of such claim has not been paid or accounted for prior to the Distribution Date, it shall be charged to the account of the party entitled to receive or who receives the benefit of the claim payment; provided, however, that if the Document under -------- ------- which the claim was made provides for any aggregate deductible, co-insurance or self-insured retention or if the claim is not fully covered because the aggregate policy limits have been exhausted, the allocation of payments under such Document shall be reallocated in accordance with the procedure shown in Schedule 1.03(c).
Claims in Process all claims that are in a pending status (data, medical, COB edits) and require review by a claim examiner prior to being released for adjudication. Because the final pay amount is unknown, the amounts are recorded at the billed amount
