Claims Investigation. We may investigate claims at Our own discretion to determine the validity of claim. Such investigation shall be concluded within 15 days from the date of assigning the claim for investigation and not later than 6 months from the date of receipt of claim intimation. Verification carried out, if any, will be done by individuals or entities authorised by Us to carry out such verification / investigation(s) and the costs for such verification / investigation shall be borne by the Us.
Claims Investigation. In the event of a claim the Company may make any investigation it deems necessary and both the Insured Person and the Policyholder shall co-operate fully with such investigation. Failure by the Insured Person or the Policyholder to co-operate with the Company’s investigation may result in denial of the claim or cancellation of the Policy.
Claims Investigation. A. Complete initial investigation answering questions such as who, what, where, when and why. Investigations shall be completed within forty-five (45) days of the Member’s knowledge of claim, including statements from participants and witnesses, appropriate official reports, investigative reports, site inspections, relevant documents and photos/videos.
Claims Investigation. (i) Investigate all reported claims to the extent the Administrator deems reasonably necessary.
Claims Investigation. DDAZ will conduct the necessary investigations and, if the facts as stated in the claim or as determined upon such investigation entitle the Plan Participant or beneficiary to receive payment of dental benefits, DDAZ will make payment according to the Plan provisions. If DDAZ finds that the Plan Participant or beneficiary is not entitled to dental benefits under the Plan, the claim for dental benefits will be denied with DDAZ's reasons for denial.
Claims Investigation. Manager shall require the assigned adjuster to handle claims in accordance with the Company’s rules and regulations and generally accepted insurance industry standards. All claims will be processed in compliance with the laws of Florida. Manager will monitor all open claim files in accordance with the Claims Guidelines, as reasonably amended from time to time. Manager will require appropriate documentation of each claim file which provides a tracing record of each loss, the investigation, the damage assessment and other pertinent information associated with each claim handling decision.
Claims Investigation. INS shall require the assigned adjuster to handle claims in accordance with the Company's rules and regulations and generally accepted insurance industry standards. All claims will be processed in compliance with law. INS will monitor all open claim files utilizing means deemed appropriate for claims settlement. INS will require appropriate documentation of each claim file which provides a tracing record of each loss, the investigation, the damage assessment and other pertinent information associated with each claim handling decision.
