Claims Payments. The Contractor shall only accept from providers the uniform claim forms approved by the Department and completed according to Department guidelines.
Claims Payments. 1. To be eligible for a Claim Payment under this Settlement, a Settlement Class Member or his or her Legally Authorized Representative must timely submit a complete Claim Form and must not have submitted a request for exclusion.
Claims Payments. Subject to the provisions of this Agreement, in exchange for its interest in Proceeds resulting from the Subject Claim pursuant to Section 7 of this Agreement, the Funder agrees to pay for the purpose of funding Fees and Expenses (defined below) regarding the Subject Claim (the “Claims Payments”) incrementally and at the Funder’s sole discretion in accordance with the Costs Plan as may be approved by the Funder from time to time.
Claims Payments. For Included Services, The Plan will send an initial payment or notice of denial of payment directly to the provider.
Claims Payments. 30. This settlement shall be a claims-made settlement. To be eligible for a Claim Payment under this settlement, a Settlement Class Member or his or her Legally Authorized Representative must timely submit a Claim Form or Electronic Claim Form and must not have submitted a request for exclusion. Allstate shall not be obligated to make any Claim Payments until after the Effective Date.
Claims Payments. The source or sources of payment under the Group Health Plan are to be only the assets of Employer, and Florida Blue will have no liability whatsoever for providing a source from which payments will be made under the Group Health Care Plan.
Claims Payments. The review, payment, settlement or compromise of all claims and losses relating to the Coinsured Policies shall be handled by the Reinsurer, in its capacity as service provider, in accordance with the terms and conditions of the Administration Agreement. The Company shall have the right to make ultimate decisions regarding the contesting, compromise, or settlement of a claim with respect to a Coinsured Policy. The Reinsurer shall be bound by all such ultimate decisions of the Company, provided that: (i) the Company shall consult with the Reinsurer prior to the Company's exercise of its decision-making authority pursuant to this Section 9.3, (ii) all decisions of the Company made hereunder shall (w) comply with the terms of the Coinsured Policies, (x) comply with all material laws, regulations and orders applicable to the Company with respect to the Coinsured Policies and to the conduct of the activities contemplated hereby, (y) be consistent with prudent management practices in the life and health insurance industry generally, and (z) comply with the Standards of Performance as referenced and described in the Administration Agreement, and (iii) the Reinsurer shall have no liability for costs and expenses incurred hereunder that arise out of, are based on or related to any bad faith claims practices, willful misconduct, fraud or gross negligence of the Company or its Affiliates (without attributing to the Company or its Affiliates the actions of the Reinsurer or its Affiliates). In the event the Company intends to exercise its decision-making authority hereunder, it shall give prompt notice to the Reinsurer of such action, but in no event later than ten (10) Business Days prior to the date of such exercise of authority, or such lesser period as is commerically reasonable for the Company and the Reinsurer under the circumstances.
Claims Payments. NYLCare Mid-Atlantic is solely responsible for making payments for any and all claims for non-capitated Covered Services in cooperation with Doctors Health and otherwise in accordance with the procedures in this Section 2.16. Claims payments to Participating Providers for non-capitated Covered Services, processed and approved strictly in accordance with this Section 2.16, shall be made by NYLCare Mid-Atlantic and then deducted from the compensation due Doctors Health under Section 2.5 of this Agreement subject to all of the conditions set forth in subparagraph 2.16.3 below.
Claims Payments. 26. This settlement shall be a claims-made settlement. To be eligible for a Claim Payment under this settlement, a Settlement Class Member or his or her Legally Authorized Representative must timely submit a Claim Form or Electronic Claim Form and must not have submitted a request for exclusion. Esurance shall not be obligated to make any Claim Payments until after the Effective Date.
Claims Payments. Payments will be mailed to Class Members within 30 days following the Effective Date upon submission of a valid claim form and after the Claims Administrator’s confirmation through the review of Teen Challenge’s records that the Class Member is entitled to relief and the Class Member’s submission of sufficient documentation demonstrating an entitlement to relief under the settlement and the Claims Administrator’s submission of a final list of all verified claims to counsel for the Parties.
