Common use of Compliance with IRO Decision Clause in Contracts

Compliance with IRO Decision. If the IRO reverses The Plan’s adverse benefit determination or final internal adverse benefit determination, The Plan will immediately provide coverage or issue payment according to the written terms and Benefits of the Contract.

Appears in 6 contracts

Samples: Health Insurance Contract, Health Insurance Contract, Health Insurance Plan

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Compliance with IRO Decision. If the IRO reverses The Plan’s adverse benefit determination or final internal adverse benefit determination, The Plan will immediately provide approve coverage that was the subject of the adverse benefit determination or issue payment final internal adverse benefit determination according to the written terms and Benefits of the Contract.

Appears in 6 contracts

Samples: Health Insurance Contract, Health Insurance Contract, Health Insurance Plan

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Compliance with IRO Decision. If the IRO reverses The Plan’s adverse benefit determination or final internal adverse benefit determination, The Plan will shall immediately provide approve coverage or issue payment according to the written terms and Benefits of the Contractrecommended or requested health care service or treatment that was the subject of the adverse benefit determination or final internal adverse benefit determination.

Appears in 6 contracts

Samples: Health Insurance Contract, Health Insurance Contract, Health Insurance Plan

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