Common use of Claims Review Procedure Clause in Contracts

Claims Review Procedure. Whenever Key decides for whatever reason to deny, whether in whole or in part, a claim for benefits under this Agreement by the Executive, Key shall transmit a written notice of its decision to the Executive, which notice shall be written in a manner calculated to be understood by the Executive and shall contain a statement of the specific reasons for the denial of the claim and a statement advising the Executive that, within 60 days of the date on which the Executive receives such notice, the Executive may obtain review of the decision of Key in accordance with the procedures hereinafter set forth. Within such 60-day period, the Executive or the Executive’s authorized representative may request that the claim denial be reviewed by filing with Key a written request therefor, which request shall contain the following information: (a) the date on which the request was filed with Key, (b) the specific portions of the denial of the Executive’s claim that the Executive requests Key to review, and (c) any written material that the Executive desires Key to examine. Within 30 days of the date specified in clause (a) of this Section 7.6, Key shall conduct a full and fair review of its decision to deny the Executive’s claim for benefits and deliver to the Executive its written decision on review, written in a manner calculated to be understood by the Executive, specifying the reasons and the Agreement provisions upon which its decision is based. Nothing in this Section 7.6 shall be construed as limiting or restricting the Executive’s right to institute legal proceedings in a court of competent jurisdiction to enforce this Agreement after complying with the procedures set forth in this Section 7.6 or as limiting or restricting the scope of the court’s review (which review shall be de novo); provided, further, that the failure of the Executive to comply with the procedures set forth in this Section 7.6 shall not bar or prohibit the subsequent compliance by the Executive with those procedures and thereafter the Executive shall have the right to institute legal proceedings to enforce this Agreement.

Claims Review Procedure. Whenever Key decides for whatever reason to deny, whether in whole or in part, a claim for benefits under this Agreement by the Executive, Key shall transmit a written notice of its decision to the Executive, which notice shall be written in a manner calculated to be understood by the Executive and shall contain a statement of the specific reasons for the denial of the claim and a statement advising the Executive that, within 60 days of the date on which the Executive receives such notice, the Executive may obtain review of the decision of Key in accordance with the procedures hereinafter set forth. Within such 60-60 day period, the Executive or the Executive’s authorized representative may request that the claim denial be reviewed by filing with Key a written request therefor, which request shall contain the following information: (a) the date on which the request was filed with Key, (b) the specific portions of the denial of the Executive’s claim that the Executive requests Key to review, and (c) any written material that the Executive desires Key to examine. Within 30 days of the date specified in clause (a) of this Section 7.6, Key shall conduct a full and fair review of its decision to deny the Executive’s claim for benefits and deliver to the Executive its written decision on review, written in a manner calculated to be understood by the Executive, specifying the reasons and the Agreement provisions upon which its decision is based. Nothing in this Section 7.6 shall be construed as limiting or restricting the Executive’s right to institute legal proceedings in a court of competent jurisdiction to enforce this Agreement after complying with the procedures set forth in this Section 7.6 or as limiting or restricting the scope of the court’s review (which review shall be de novo); provided, further, that the failure of the Executive to comply with the procedures set forth in this Section 7.6 shall not bar or prohibit the subsequent compliance by the Executive with those procedures and thereafter the Executive shall have the right to institute legal proceedings to enforce this Agreement.

Claims Review Procedure. Whenever Key decides for whatever reason to deny, whether in whole or in part, a claim for benefits under this Agreement by the Executive, Key shall transmit a written notice of its decision to the Executive, which notice shall be written in a manner calculated to be understood by the Executive and shall contain a statement of the specific reasons for the denial of the claim and a statement advising the Executive that, within 60 days of the date on which the Executive receives such notice, the Executive may obtain review of the decision of Key in accordance with the procedures hereinafter set forth. Within such 60-day period, the Executive or the Executive’s 's authorized representative may request that the claim denial be reviewed by filing with Key a written request therefor, which request shall contain the following information: (a) the date on which the request was filed with Key, (b) the specific portions of the denial of the Executive’s 's claim that the Executive requests Key to review, and (c) any written material that the Executive desires Key to examine. Within 30 days of the date specified in clause (a) of this Section 7.66.6, Key shall conduct a full and fair review of its decision to deny the Executive’s 's claim for benefits and deliver to the Executive its written decision on review, written in a manner calculated to be understood by the Executive, specifying the reasons and the Agreement provisions upon which its decision is based. Nothing in this Section 7.6 6.6 shall be construed as limiting or restricting the Executive’s 's right to institute legal proceedings in a court of competent jurisdiction to enforce this Agreement after complying with the procedures set forth in this Section 7.6 6.6 or as limiting or restricting the scope of the court’s 's review (which review shall be de novo); provided, further, that the failure of the Executive to comply with the procedures set forth in this Section 7.6 6.6 shall not bar or prohibit the subsequent compliance by the Executive with those procedures and thereafter the Executive shall have the right to institute legal proceedings to enforce this Agreement.

Claims Review Procedure. Whenever Key the Committee decides for whatever reason to deny, whether in whole or in part, a claim for benefits under this Agreement filed by any person (hereinafter referred to as the Executive"Claimant"), Key the Plan Administrator shall transmit a written notice of its the Committee's decision to the ExecutiveClaimant, which notice shall be written in a manner calculated to be understood by the Executive Claimant and shall contain a statement of the specific reasons for the denial of the claim and a statement advising the Executive Claimant that, within 60 days of the date on which the Executive he receives such notice, the Executive he may obtain review of the decision of Key the Committee in accordance with the procedures hereinafter set forth. Within such 60-day period, the Executive Claimant or the Executive’s his authorized representative may request that the claim denial be reviewed by filing with Key the Plan Administrator a written request therefortherefore, which request shall contain the following information: (a) the date on which the Claimant's request was filed with Key,the Plan Administrator; provided, however, that the date on which the Claimant's request for review was in fact filed with the Plan Administrator shall control in the event that the date of the actual filing is later than the date stated by the Claimant pursuant to this subsection 12.5(a); (b) the specific portions of the denial of his claim which the Executive’s claim that Claimant requests the Executive requests Key Plan Administrator to review, and; 76 - 71 - (c) a statement by the Claimant setting forth the basis upon which he believes the Plan Administrator should reverse the Committee's previous denial of his claim for benefits and accept this claim as made; and (d) any written material that (offered as exhibits) which the Executive Claimant desires Key the Plan Administrator to examineexamine in its consideration of his position as stated pursuant to subsection 12.5(c). Within 30 60 days of the date specified in clause (a) of this Section 7.6determined pursuant to subsection 12.5(a), Key the Plan Administrator shall conduct a full and fair review of its the Committee's decision to deny denying the Executive’s Claimant's claim for benefits and deliver to benefits. Within 60 days of the Executive date of such hearing, the Plan Administrator shall render its written decision on review, written in a manner calculated to be understood by the ExecutiveClaimant, specifying the reasons and the Agreement Plan provisions upon which its decision is was based. Nothing in this Section 7.6 shall be construed as limiting or restricting the Executive’s right to institute legal proceedings in a court of competent jurisdiction to enforce this Agreement after complying with the procedures set forth in this Section 7.6 or as limiting or restricting the scope of the court’s review (which review shall be de novo); provided, further, that the failure of the Executive to comply with the procedures set forth in this Section 7.6 shall not bar or prohibit the subsequent compliance by the Executive with those procedures and thereafter the Executive shall have the right to institute legal proceedings to enforce this Agreement.

Claims Review Procedure. Whenever Key decides for whatever reason Any Employee, Former Employee, or Beneficiary of either, who has been denied a benefit by a decision of the Administrator pursuant to deny, whether in whole or in part, Section 2.8 shall be entitled to request the Administrator to give further consideration to a claim by filing with the Administrator a written request for benefits under this Agreement a hearing. Such request, together with a written statement of the reasons why the claimant believes the claim should be allowed, shall be filed with the Administrator no later than sixty (60) days (45 days if the claim involves disability benefits) after receipt of the written notification provided for in Section 2.8. The Administrator shall then conduct a hearing within the next 60 days (45 days if the claim involves disability benefits), at which the claimant may be represented by an attorney or any other representative of such claimant’s choosing and expense and at which the claimant shall have an opportunity to submit written and oral evidence and arguments in support of the claim. At the hearing the claimant or the claimant’s representative shall have an opportunity to review all documents in the possession of the Administrator which are pertinent to the claim at issue and its disallowance. A final decision as to the allowance of the claim shall be made by the ExecutiveAdministrator within sixty (60) days (45 days if the claim involves disability benefits) of receipt of the appeal (unless there has been an extension of sixty (60) days (45 days if the claim involves disability benefits) due to special circumstances, Key shall transmit a written notice of its decision provided the delay and the special circumstances occasioning it are communicated to the Executive, which notice claimant within the 60-day period (45 days if the claim involves disability benefits)). Such communication shall be written in a manner calculated to be understood by the Executive claimant and shall contain a statement of the include specific reasons for the denial of decision and specific references to the claim and a statement advising the Executive that, within 60 days of the date pertinent Plan provisions on which the Executive receives such notice, the Executive may obtain review of the decision of Key in accordance with the procedures hereinafter set forth. Within such 60-day period, the Executive or the Executive’s authorized representative may request that the claim denial be reviewed by filing with Key a written request therefor, which request shall contain the following information: (a) the date on which the request was filed with Key, (b) the specific portions of the denial of the Executive’s claim that the Executive requests Key to review, and (c) any written material that the Executive desires Key to examine. Within 30 days of the date specified in clause (a) of this Section 7.6, Key shall conduct a full and fair review of its decision to deny the Executive’s claim for benefits and deliver to the Executive its written decision on review, written in a manner calculated to be understood by the Executive, specifying the reasons and the Agreement provisions upon which its decision is based. Nothing Notwithstanding the preceding, to the extent any of the time periods specified in this Section 7.6 are amended by law or Department of Labor regulation, then the time frames specified herein shall automatically be construed as limiting changed in accordance with such law or restricting regulation. If the ExecutiveAdministrator, pursuant to the claims review procedure, makes a final written determination denying a Participant’s right or Beneficiary’s benefit claim, then in order to institute legal proceedings in a court of competent jurisdiction preserve the claim, the Participant or Beneficiary must file an action with respect to enforce this Agreement after complying with the procedures set forth in this Section 7.6 or as limiting or restricting denied claim not later than one hundred eighty (180) days following the scope date of the courtAdministrator’s review (which review shall be de novo); provided, further, that the failure of the Executive to comply with the procedures set forth in this Section 7.6 shall not bar or prohibit the subsequent compliance by the Executive with those procedures and thereafter the Executive shall have the right to institute legal proceedings to enforce this Agreementfinal determination.

Claims Review Procedure. Whenever Key decides (a) No participant, active or retired, dependent or beneficiary of either, or other person shall have any right or claim to benefits under the Plan, other than as specified in such eligibility resolutions as the Directors shall determine and establish. If any claimant shall have a dispute as to eligibility, type, amount, or duration of such benefits, the dispute shall be resolved by the Claims Review Committee of the Board of Directors as hereinafter set forth. Said Committee shall consist of the members of the Benefits Committee as appointed by the Chairman. Notwithstanding the foregoing, in the event that the Plan offers HMO or similar benefit options to participants, including benefits that require pre- authorization, it may delegate to an entity administering such benefits the authority to provide its own claims review procedure and/or interpret the terms of said benefits. (b) Any person whose application for whatever reason to deny, whether benefits under the Plan has been denied in whole or in part, a claim for benefits under this Agreement by the Executive, Key part shall transmit a written notice be notified of its such decision to the Executive, which in writing. Such notice shall be written in a manner calculated to be understood by the Executive and shall contain a statement of set forth the specific reason or reasons for the denial, contain specific references to pertinent Plan provisions upon which the denial of is based, state any internal rule, guideline, protocol or similar criterion which has been relied on (or state that such will be supplied, at no cost, upon request), describe any additional material or information necessary for the claimant to perfect the claim and explain why such material or information is necessary, and explain the Plan's claim review procedure. If the determination was based on lack of medical necessity, experimental treatment or similar exclusion, an explanation of the clinical or scientific judgment shall be provided or it will be stated that such will be provided, at no cost, upon request. If the claimant desires further consideration of the decision denying the claim, he may request a statement advising review upon written application to the Executive thatPlan. In connection with such request for review, the claimant shall upon request, be entitled to review and receive copies of pertinent documents, at no cost. The Claimant may also submit additional documentation, issues and comments in writing to the Plan Administrative Director which shall be considered by the Board of Directors in arriving at a decision on review. Such request for review shall state in clear and concise terms the reason or reasons for disagreement with the decision, and shall be filed with the Plan Administrative Director's office within 60 one hundred eighty (180) days after receipt by the claimant of the decision denying the claim The failure to file a request for review within such one hundred and eighty (180) day period shall constitute a waiver of the claimant's right to review of the decision and such decision shall be final and binding upon all parties thereto. Such failure shall not, however, 62 ADDED 1/22/76 (Amendment XXVIII) Section AMENDED 3/14/88 (Amendment XLIII) Section AMENDED 12/18/02 (Amendment LXXIII), effective 1/1/03. Agreement and Declaration of Trust (Inclusive of Amendments I through CXXXII) preclude the applicant or claimant from establishing entitlement at a later date based on additional information and evidence which was not available at the time of the decision on the claim for benefits. (c) Upon receipt of a request for review, the Claims Review Committee shall proceed to review the administrative file, including the request for review and its contents. A decision by the Claims Review Committee shall be made By the next meeting of the Committee following the request for review, however, if the request is received within thirty (30) days of such meeting, the decision may be rendered by the next meeting. In the event of special circumstances, the appeal may be decided no later than the third meeting following the request for review. If such special circumstances exist, the person requesting the review will be notified in writing prior to the special circumstances extension and informed of the reasons for the extension and the date on which the Executive receives such notice, the Executive may obtain review appeal will be decided. The claimant shall be advised of the decision of Key the Claims Review Committee in accordance with writing, no later than five (5) days after the procedures hereinafter set forth. Within such 60-day period, decision is made which decision shall include specific reasons for the Executive or the Executive’s authorized representative may request that the claim denial be reviewed by filing with Key a written request therefor, which request shall contain the following information: (a) the date on which the request was filed with Key, (b) the specific portions of the denial of the Executive’s claim that the Executive requests Key decision and references to review, and (c) any written material that the Executive desires Key to examine. Within 30 days of the date specified in clause (a) of this Section 7.6, Key shall conduct a full and fair review of its decision to deny the Executive’s claim for benefits and deliver to the Executive its written decision on review, written in a manner calculated to be understood by the Executive, specifying the reasons and the Agreement pertinent Plan provisions upon which its the decision is based. Nothing If an adverse determination is based on lack of medical necessity, experimental treatment or similar exclusion, an explanation of the clinical or scientific judgment will be provided or, in this Section 7.6 the alternative, it shall be construed as limiting stated that such explanation will be furnished, upon request, at no cost. If an internal Plan rule, guideline, protocol or restricting similar criterion is being relied on, such will be identified and either provided at that time or the Executive’s right claimant will be informed that it will be made available, at no cost, upon request. (d) The Claims Review Committee shall make an independent determination of the appeal, in the sense that it will not defer to institute legal proceedings the decision of the initial decision maker. If the appeal is based on a medical judgment, including any determination whether a medical treatment is medically necessary, experimental, or of similar nature, the review conducted by the Committee will utilize a health care professional knowledgeable in a court of competent jurisdiction to enforce this Agreement after complying the pertinent area who was not consulted in connection with the procedures set forth initial benefit determination, and who is not a subordinate of any such person. The Plan shall, upon request from the person whose claim was denied, identify any medical or vocational experts whose advice was obtained in this Section 7.6 or as limiting or restricting the scope connection with an adverse benefit determination. (e) The decision of the court’s review (which review Claims Review Committee shall be de novo)final and binding upon all parties, including the claimant; provided, furtherhowever, that any notification of determination on appeal shall state that the failure of the Executive to comply with the procedures set forth in this Section 7.6 shall not bar or prohibit the subsequent compliance by the Executive with those procedures and thereafter the Executive shall have claimant has the right to institute legal proceedings bring a civil action under Section 502(a) of ERISA and any person claiming under the claimant. The provisions of this section shall apply to enforce this Agreementand include any and every claim to benefits under the Plan and any claim or right asserted against the Plan, regardless of the basis asserted for the claim and regardless of when the act or omission upon which the claim is based occurred, subject to Section 9(a) above.

Claims Review Procedure. Whenever Key decides (a) No participant, active or retired, dependent or beneficiary of either, or other person shall have any right or claim to benefits under the Plan, other than as specified in such eligibility resolutions as the Directors shall determine and establish. If any claimant shall have a dispute as to eligibility, type, amount, or duration of such benefits, the dispute shall be resolved by the Claims Review Committee of the Board of Directors as hereinafter set forth. Said Committee shall consist of the members of the Benefits Committee as appointed by the Chairman. Notwithstanding the foregoing, in the event that the Plan offers HMO or similar benefit options to participants, including benefits that require pre- authorization, it may delegate to an entity administering such benefits the authority to provide its own claims review procedure and/or interpret the terms of said benefits. (b) Any person whose application for whatever reason to deny, whether benefits under the Plan has been denied in whole or in part, a claim for benefits under this Agreement by the Executive, Key part shall transmit a written notice be notified of its such decision to the Executive, which in writing. Such notice shall be written in a manner calculated to be understood by the Executive and shall contain a statement of set forth the specific reason or reasons for the denial, contain specific references to pertinent Plan provisions upon which the denial of is based, state any internal rule, guideline, protocol or similar criterion which has been relied on (or state that such will be supplied, at no cost, upon request), describe any additional material or information necessary for the claimant to perfect the claim and explain why such material or information is necessary, and explain the Plan's claim review procedure. If the determination was based on lack of medical necessity, experimental treatment or similar exclusion, an explanation of the clinical or scientific judgment shall be provided or it will be stated that such will be provided, at no cost, upon request. If the claimant desires further consideration of the decision denying the claim, he may request a statement advising review upon written application to the Executive thatPlan. In connection with such request for review, the claimant shall upon request, be entitled to review and receive copies of pertinent documents, at no cost. The Claimant may also submit additional documentation, issues and comments in writing to the Plan Administrative Director which shall be considered by the Board of Directors in arriving at a decision on review. Such request for review shall state in clear and concise terms the reason or reasons for disagreement with the decision, and shall be filed with the Plan Administrative Director's office within 60 one hundred eighty (180) days after receipt by the claimant of the decision denying the claim The failure to file a request for review within such one hundred and eighty (180) day period shall constitute a waiver of the claimant's right to review of the decision and such decision shall be final and binding upon all parties thereto. Such failure shall not, however, 62 ADDED 1/22/76 (Amendment XXVIII) Section AMENDED 3/14/88 (Amendment XLIII) Section AMENDED 12/18/02 (Amendment LXXIII), effective 1/1/03. Agreement and Declaration of Trust (Inclusive of Amendments I through CXXXV) preclude the applicant or claimant from establishing entitlement at a later date based on additional information and evidence which was not available at the time of the decision on the claim for benefits. (c) Upon receipt of a request for review, the Claims Review Committee shall proceed to review the administrative file, including the request for review and its contents. A decision by the Claims Review Committee shall be made By the next meeting of the Committee following the request for review, however, if the request is received within thirty (30) days of such meeting, the decision may be rendered by the next meeting. In the event of special circumstances, the appeal may be decided no later than the third meeting following the request for review. If such special circumstances exist, the person requesting the review will be notified in writing prior to the special circumstances extension and informed of the reasons for the extension and the date on which the Executive receives such notice, the Executive may obtain review appeal will be decided. The claimant shall be advised of the decision of Key the Claims Review Committee in accordance with writing, no later than five (5) days after the procedures hereinafter set forth. Within such 60-day period, decision is made which decision shall include specific reasons for the Executive or the Executive’s authorized representative may request that the claim denial be reviewed by filing with Key a written request therefor, which request shall contain the following information: (a) the date on which the request was filed with Key, (b) the specific portions of the denial of the Executive’s claim that the Executive requests Key decision and references to review, and (c) any written material that the Executive desires Key to examine. Within 30 days of the date specified in clause (a) of this Section 7.6, Key shall conduct a full and fair review of its decision to deny the Executive’s claim for benefits and deliver to the Executive its written decision on review, written in a manner calculated to be understood by the Executive, specifying the reasons and the Agreement pertinent Plan provisions upon which its the decision is based. Nothing If an adverse determination is based on lack of medical necessity, experimental treatment or similar exclusion, an explanation of the clinical or scientific judgment will be provided or, in this Section 7.6 the alternative, it shall be construed as limiting stated that such explanation will be furnished, upon request, at no cost. If an internal Plan rule, guideline, protocol or restricting similar criterion is being relied on, such will be identified and either provided at that time or the Executive’s right claimant will be informed that it will be made available, at no cost, upon request. (d) The Claims Review Committee shall make an independent determination of the appeal, in the sense that it will not defer to institute legal proceedings the decision of the initial decision maker. If the appeal is based on a medical judgment, including any determination whether a medical treatment is medically necessary, experimental, or of similar nature, the review conducted by the Committee will utilize a health care professional knowledgeable in a court of competent jurisdiction to enforce this Agreement after complying the pertinent area who was not consulted in connection with the procedures set forth initial benefit determination, and who is not a subordinate of any such person. The Plan shall, upon request from the person whose claim was denied, identify any medical or vocational experts whose advice was obtained in this Section 7.6 or as limiting or restricting the scope connection with an adverse benefit determination. (e) The decision of the court’s review (which review Claims Review Committee shall be de novo)final and binding upon all parties, including the claimant; provided, furtherhowever, that any notification of determination on appeal shall state that the failure of the Executive to comply with the procedures set forth in this Section 7.6 shall not bar or prohibit the subsequent compliance by the Executive with those procedures and thereafter the Executive shall have claimant has the right to institute legal proceedings bring a civil action under Section 502(a) of ERISA and any person claiming under the claimant. The provisions of this section shall apply to enforce this Agreementand include any and every claim to benefits under the Plan and any claim or right asserted against the Plan, regardless of the basis asserted for the claim and regardless of when the act or omission upon which the claim is based occurred, subject to Section 9(a) above.

Claims Review Procedure. Whenever Key decides (a) No participant, active or retired, dependent or beneficiary of either, or other person shall have any right or claim to benefits under the Plan, other than as specified in such eligibility resolutions as the Directors shall determine and establish. If any claimant shall have a dispute as to eligibility, type, amount, or duration of such benefits, the dispute shall be resolved by the Claims Review Committee of the Board of Directors as hereinafter set forth. Said Committee shall consist of the members of the Benefits Committee as appointed by the Chairman. Notwithstanding the foregoing, in the event that the Plan offers HMO or similar benefit options to participants, including benefits that require pre- authorization, it may delegate to an entity administering such benefits the authority to provide its own claims review procedure and/or interpret the terms of said benefits. (b) Any person whose application for whatever reason to deny, whether benefits under the Plan has been denied in whole or in part, a claim for benefits under this Agreement by the Executive, Key part shall transmit a written notice be notified of its such decision to the Executive, which in writing. Such notice shall be written in a manner calculated to be understood by the Executive and shall contain a statement of set forth the specific reason or reasons for the denial, contain specific references to pertinent Plan provisions upon which the denial of is based, state any internal rule, guideline, protocol or similar criterion which has been relied on (or state that such will be supplied, at no cost, upon request), describe any additional material or information necessary for the claimant to perfect the claim and explain why such material or information is necessary, and explain the Plan's claim review procedure. If the determination was based on lack of medical necessity, experimental treatment or similar exclusion, an explanation of the clinical or scientific judgment shall be provided or it will be stated that such will be provided, at no cost, upon request. If the claimant desires further consideration of the decision denying the claim, he may request a statement advising review upon written application to the Executive thatPlan. In connection with such request for review, the claimant shall upon request, be entitled to review and receive copies of pertinent documents, at no cost. The Claimant may also submit additional documentation, issues and comments in writing to the Plan Administrative Director which shall be considered by the Board of Directors in arriving at a decision on review. Such request for review shall state in clear and concise terms the reason or reasons for disagreement with the decision, and shall be filed with the Plan Administrative Director's office within 60 one hundred eighty (180) days after receipt by the claimant of the decision denying the claim The failure to file a request for review within such one hundred and eighty (180) day period shall constitute a waiver of the claimant's right to review of the decision and such decision shall be final and binding upon all parties thereto. Such failure shall not, however, 62 ADDED 1/22/76 (Amendment XXVIII) Section AMENDED 3/14/88 (Amendment XLIII) Section AMENDED 12/18/02 (Amendment LXXIII), effective 1/1/03. Agreement and Declaration of Trust (Inclusive of Amendments I through CXXXVI) preclude the applicant or claimant from establishing entitlement at a later date based on additional information and evidence which was not available at the time of the decision on the claim for benefits. (c) Upon receipt of a request for review, the Claims Review Committee shall proceed to review the administrative file, including the request for review and its contents. A decision by the Claims Review Committee shall be made By the next meeting of the Committee following the request for review, however, if the request is received within thirty (30) days of such meeting, the decision may be rendered by the next meeting. In the event of special circumstances, the appeal may be decided no later than the third meeting following the request for review. If such special circumstances exist, the person requesting the review will be notified in writing prior to the special circumstances extension and informed of the reasons for the extension and the date on which the Executive receives such notice, the Executive may obtain review appeal will be decided. The claimant shall be advised of the decision of Key the Claims Review Committee in accordance with writing, no later than five (5) days after the procedures hereinafter set forth. Within such 60-day period, decision is made which decision shall include specific reasons for the Executive or the Executive’s authorized representative may request that the claim denial be reviewed by filing with Key a written request therefor, which request shall contain the following information: (a) the date on which the request was filed with Key, (b) the specific portions of the denial of the Executive’s claim that the Executive requests Key decision and references to review, and (c) any written material that the Executive desires Key to examine. Within 30 days of the date specified in clause (a) of this Section 7.6, Key shall conduct a full and fair review of its decision to deny the Executive’s claim for benefits and deliver to the Executive its written decision on review, written in a manner calculated to be understood by the Executive, specifying the reasons and the Agreement pertinent Plan provisions upon which its the decision is based. Nothing If an adverse determination is based on lack of medical necessity, experimental treatment or similar exclusion, an explanation of the clinical or scientific judgment will be provided or, in this Section 7.6 the alternative, it shall be construed as limiting stated that such explanation will be furnished, upon request, at no cost. If an internal Plan rule, guideline, protocol or restricting similar criterion is being relied on, such will be identified and either provided at that time or the Executive’s right claimant will be informed that it will be made available, at no cost, upon request. (d) The Claims Review Committee shall make an independent determination of the appeal, in the sense that it will not defer to institute legal proceedings the decision of the initial decision maker. If the appeal is based on a medical judgment, including any determination whether a medical treatment is medically necessary, experimental, or of similar nature, the review conducted by the Committee will utilize a health care professional knowledgeable in a court of competent jurisdiction to enforce this Agreement after complying the pertinent area who was not consulted in connection with the procedures set forth initial benefit determination, and who is not a subordinate of any such person. The Plan shall, upon request from the person whose claim was denied, identify any medical or vocational experts whose advice was obtained in this Section 7.6 or as limiting or restricting the scope connection with an adverse benefit determination. (e) The decision of the court’s review (which review Claims Review Committee shall be de novo)final and binding upon all parties, including the claimant; provided, furtherhowever, that any notification of determination on appeal shall state that the failure of the Executive to comply with the procedures set forth in this Section 7.6 shall not bar or prohibit the subsequent compliance by the Executive with those procedures and thereafter the Executive shall have claimant has the right to institute legal proceedings bring a civil action under Section 502(a) of ERISA and any person claiming under the claimant. The provisions of this section shall apply to enforce this Agreementand include any and every claim to benefits under the Plan and any claim or right asserted against the Plan, regardless of the basis asserted for the claim and regardless of when the act or omission upon which the claim is based occurred, subject to Section 9(a) above.

Claims Review Procedure. Whenever Key decides (a) No participant, active or retired, dependent or beneficiary of either, or other person shall have any right or claim to benefits under the Plan, other than as specified in such eligibility resolutions as the Directors shall determine and establish. If any claimant shall have a dispute as to eligibility, type, amount, or duration of such benefits, the dispute shall be resolved by the Claims Review Committee of the Board of Directors as hereinafter set forth. Said Committee shall consist of the members of the Benefits Committee as appointed by the Chairman. Notwithstanding the foregoing, in the event that the Plan offers HMO or similar benefit options to participants, including benefits that require pre- authorization, it may delegate to an entity administering such benefits the authority to provide its own claims review procedure and/or interpret the terms of said benefits. (b) Any person whose application for whatever reason to deny, whether benefits under the Plan has been denied in whole or in part, a claim for benefits under this Agreement by the Executive, Key part shall transmit a written notice be notified of its such decision to the Executive, which in writing. Such notice shall be written in a manner calculated to be understood by the Executive and shall contain a statement of set forth the specific reason or reasons for the denial, contain specific references to pertinent Plan provisions upon which the denial of is based, state any internal rule, guideline, protocol or similar criterion which has been relied on (or state that such will be supplied, at no cost, upon request), describe any additional material or information necessary for the claimant to perfect the claim and explain why such material or information is necessary, and explain the Plan's claim review procedure. If the determination was based on lack of medical necessity, experimental treatment or similar exclusion, an explanation of the clinical or scientific judgment shall be provided or it will be stated that such will be provided, at no cost, upon request. If the claimant desires further consideration of the decision denying the claim, he may request a statement advising review upon written application to the Executive thatPlan. In connection with such request for review, the claimant shall upon request, be entitled to review and receive copies of pertinent documents, at no cost. The Claimant may also submit additional documentation, issues and comments in writing to the Plan Administrative Director which shall be considered by the Board of Directors in arriving at a decision on review. Such request for review shall state in clear and concise terms the reason or reasons for disagreement with the decision, and shall be filed with the Plan Administrative Director's office within 60 one hundred eighty (180) days after receipt by the claimant of the decision denying the claim The failure to file a request for review within such one hundred and eighty (180) day period shall constitute a waiver of the claimant's right to review of the decision and such decision shall be final and binding upon all parties thereto. Such failure shall not, however, 62 ADDED 1/22/76 (Amendment XXVIII) Section AMENDED 3/14/88 (Amendment XLIII) Section AMENDED 12/18/02 (Amendment LXXIII), effective 1/1/03. Agreement and Declaration of Trust (Inclusive of Amendments I through CXXX) preclude the applicant or claimant from establishing entitlement at a later date based on additional information and evidence which was not available at the time of the decision on the claim for benefits. (c) Upon receipt of a request for review, the Claims Review Committee shall proceed to review the administrative file, including the request for review and its contents. A decision by the Claims Review Committee shall be made By the next meeting of the Committee following the request for review, however, if the request is received within thirty (30) days of such meeting, the decision may be rendered by the next meeting. In the event of special circumstances, the appeal may be decided no later than the third meeting following the request for review. If such special circumstances exist, the person requesting the review will be notified in writing prior to the special circumstances extension and informed of the reasons for the extension and the date on which the Executive receives such notice, the Executive may obtain review appeal will be decided. The claimant shall be advised of the decision of Key the Claims Review Committee in accordance with writing, no later than five (5) days after the procedures hereinafter set forth. Within such 60-day period, decision is made which decision shall include specific reasons for the Executive or the Executive’s authorized representative may request that the claim denial be reviewed by filing with Key a written request therefor, which request shall contain the following information: (a) the date on which the request was filed with Key, (b) the specific portions of the denial of the Executive’s claim that the Executive requests Key decision and references to review, and (c) any written material that the Executive desires Key to examine. Within 30 days of the date specified in clause (a) of this Section 7.6, Key shall conduct a full and fair review of its decision to deny the Executive’s claim for benefits and deliver to the Executive its written decision on review, written in a manner calculated to be understood by the Executive, specifying the reasons and the Agreement pertinent Plan provisions upon which its the decision is based. Nothing If an adverse determination is based on lack of medical necessity, experimental treatment or similar exclusion, an explanation of the clinical or scientific judgment will be provided or, in this Section 7.6 the alternative, it shall be construed as limiting stated that such explanation will be furnished, upon request, at no cost. If an internal Plan rule, guideline, protocol or restricting similar criterion is being relied on, such will be identified and either provided at that time or the Executive’s right claimant will be informed that it will be made available, at no cost, upon request. (d) The Claims Review Committee shall make an independent determination of the appeal, in the sense that it will not defer to institute legal proceedings the decision of the initial decision maker. If the appeal is based on a medical judgment, including any determination whether a medical treatment is medically necessary, experimental, or of similar nature, the review conducted by the Committee will utilize a health care professional knowledgeable in a court of competent jurisdiction to enforce this Agreement after complying the pertinent area who was not consulted in connection with the procedures set forth initial benefit determination, and who is not a subordinate of any such person. The Plan shall, upon request from the person whose claim was denied, identify any medical or vocational experts whose advice was obtained in this Section 7.6 or as limiting or restricting the scope connection with an adverse benefit determination. (e) The decision of the court’s review (which review Claims Review Committee shall be de novo)final and binding upon all parties, including the claimant; provided, furtherhowever, that any notification of determination on appeal shall state that the failure of the Executive to comply with the procedures set forth in this Section 7.6 shall not bar or prohibit the subsequent compliance by the Executive with those procedures and thereafter the Executive shall have claimant has the right to institute legal proceedings bring a civil action under Section 502(a) of ERISA and any person claiming under the claimant. The provisions of this section shall apply to enforce this Agreementand include any and every claim to benefits under the Plan and any claim or right asserted against the Plan, regardless of the basis asserted for the claim and regardless of when the act or omission upon which the claim is based occurred, subject to Section 9(a) above.

Claims Review Procedure. Whenever Key decides for whatever reason to deny, whether in whole or in part, a claim for benefits under this Agreement by the Executive, Key shall transmit a written notice of its decision to the Executive, which notice shall be written in a manner calculated to be understood by the Executive and shall contain a statement of the specific reasons for the denial of the claim and a statement advising the Executive that, within 60 days of the date on which the Executive receives such notice, the Executive may obtain review of the decision of Key in accordance with the procedures hereinafter set forth. Within such 60-day period, the Executive or the Executive’s 's authorized representative may request that the claim denial be reviewed by filing with Key a written request therefortherefore, which request shall contain the following information: (a) the date on which the request was filed with Key, (b) the specific portions of the denial of the Executive’s 's claim that the Executive requests Key to review, and (c) any written material that the Executive desires Key to examine. Within 30 days of the date specified in clause (a) of this Section 7.6, Key shall conduct a full and fair review of its decision to deny the Executive’s 's claim for benefits and deliver to the Executive its written decision on review, written in a manner calculated to be understood by the Executive, specifying the reasons and the Agreement provisions upon which its decision is based. Nothing in this Section 7.6 shall be construed as limiting or restricting the Executive’s 's right to institute legal proceedings in a court of competent jurisdiction to enforce this Agreement after complying with the procedures set forth in this Section 7.6 or as limiting or restricting the scope of the court’s 's review (which review shall be de novo); provided, further, that the failure of the Executive to comply with the procedures set forth in this Section 7.6 shall not bar or prohibit the subsequent compliance by the Executive with those procedures and thereafter the Executive shall have the right to institute legal proceedings to enforce this Agreement.

Claims Review Procedure. Whenever Key decides Any Claimant who has been denied a benefit by a decision of the Administrator pursuant to Section 3.5 shall be entitled to request the Administrator to give further consideration to his claim by filing with the Administrator a request for whatever reason a hearing. Such request, together with a written statement of the reasons why the Claimant believes his claim should be allowed, shall be filed with the Administrator no later than 60 days after receipt of the written notification provided for in Section 3.5. The Claimant shall be provided, upon request and free of charge, reasonable access to, and copies of, all documents, records and other information relevant to denythe Claimant’s claim for benefits. Upon written notification of a Claimant’s request for a hearing, the Board shall appoint a committee of three, none of whom are either the individual who made the adverse benefit determination that is the subject of the appeal, nor the subordinate of such individual. Such committee shall conduct a hearing within the next 60 days, at which the Claimant shall have the right to appear in person and an opportunity to submit comments, documents, records and other information relating to the claim without regard to whether such information was submitted or considered in whole or in part, the initial benefit determination. The appointed committee shall make a final decision as to the allowance of a claim for benefits under this Agreement by based on disability within 45 days, or within 90 days if special circumstances require an extension of time. Decisions as to all other claims will be made within 60 days of receipt of the Executiveappeal (unless there has been an extension due to special circumstances, Key shall transmit a written notice of its decision provided the delay and the special circumstances occasioning it are communicated to the ExecutiveClaimant in writing within the 60 day period), in which case a decision shall be rendered as soon as possible but not later than 120 days after receipt of the request for review; provided, however, that in the event the Claimant fails to submit information necessary to make a benefit determination on review, such period shall be tolled from the date on which the extension notice is sent to the Claimant until the date on which the Claimant responds to the request for additional information. The decision on review shall be written or electronic and, in the case of an adverse determination, shall include specific reasons for the decision, in a manner calculated to be understood by the Executive Claimant, and specific references to the pertinent Plan provisions on which the decision is based. The decision on review shall contain also include (i) a statement that the Claimant is entitled to receive, upon request and free of charge, reasonable access to, and copies of, all documents, records and other information relevant to the Claimant’s claim for benefits, and (ii) a statement describing any voluntary appeal procedures offered by the Plan, and a statement of the Claimant’s right, if any, to bring an action and shall include specific reasons for the denial of decision and specific references to the claim and a statement advising the Executive that, within 60 days of the date pertinent Plan provisions on which the Executive receives such notice, the Executive may obtain review of the decision of Key is based. The procedures set forth in Sections 3.5 and 3.6 shall be administered in accordance with the procedures hereinafter set forth. Within such 60-day period, the Executive or the Executive’s authorized representative may request that the claim denial be reviewed by filing with Key a written request therefor, which request shall contain the following information: (a) the date on which the request was filed with Key, (b) the specific portions claims procedure regulations of the denial Department of Labor set forth at 29 C.F.R. 2560.503-1. No Claimant shall bring suit under the Executive’s claim that the Executive requests Key to review, and (c) any written material that the Executive desires Key to examine. Within 30 days of the date specified in clause (a) of this Section 7.6, Key shall conduct a full Plan unless and fair review of its decision to deny the Executive’s claim for benefits and deliver to the Executive its written decision on review, written in a manner calculated to be understood by the Executive, specifying the reasons and the Agreement provisions upon which its decision is based. Nothing in this Section 7.6 shall be construed as limiting until he or restricting the Executive’s she has exhausted his or her right to institute legal proceedings in a court of competent jurisdiction to enforce this Agreement after complying with review under the procedures set forth in this Section 7.6 or as limiting or restricting the scope of the courtPlan’s review (which review shall be de novo); provided, further, that the failure of the Executive to comply with the procedures set forth in this Section 7.6 shall not bar or prohibit the subsequent compliance by the Executive with those procedures and thereafter the Executive shall have the right to institute legal proceedings to enforce this Agreementclaims procedures.

Claims Review Procedure. Whenever Key decides for whatever reason to deny, whether in whole or in part, a claim for benefits under this Agreement by the Executive, Key shall transmit a written notice of its decision to the Executive, which notice shall be written in a manner calculated to be understood by the Executive and shall contain a statement of the specific reasons for the denial of the claim and a statement advising the Executive that, within 60 days of the date on which the Executive receives such notice, the Executive may obtain review of the decision of Key in accordance with the procedures hereinafter set forth. Within such 60-day period, the Executive or the Executive’s 's authorized representative may request that the claim denial be reviewed by filing with Key a written request therefor, which request shall contain the following information: (a) the date on which the request was filed with Key, (b) the specific portions of the denial of the Executive’s 's claim that the Executive requests Key to review, and (c) any written material that the Executive desires Key to examine. Within 30 days of the date specified in clause (a) of this Section 7.6, Key shall conduct a full and fair review of its decision to deny the Executive’s 's claim for benefits and deliver to the Executive its written decision on review, written in a manner calculated to be understood by the Executive, specifying the reasons and the Agreement provisions upon which its decision is based. Nothing in this Section 7.6 shall be construed as limiting or restricting the Executive’s 's right to institute legal proceedings in a court of competent jurisdiction to enforce this Agreement after complying with the procedures set forth in this Section 7.6 or as limiting or restricting the scope of the court’s 's review (which review shall be de novo); provided, further, that the failure of the Executive to comply with the procedures set forth in this Section 7.6 shall not bar or prohibit the subsequent compliance by the Executive with those procedures and thereafter the Executive shall have the right to institute legal proceedings to enforce this Agreement.