Conditions Requiring Claims Consultation. Before conceding liability or making settlement to the claimant, the Company will seek the Reinsurer’s recommendation if:
a) The claim occurs during the contestable period and the Company is not contesting the claim; or
b) The death occurs outside of the United States or Canada; or
c) The claim is one for which there is no body, i.e. the insured is missing and presumed dead.
Conditions Requiring Claims Consultation. Before conceding liability or making settlement to the claimant, the Company will seek the Reinsurer’s recommendation if:
a) The claim occurs during the contestable period and the Company is not contesting the claim, but the Reinsurer's share exceeds $1,000,000; or
b) The death occurs outside of the United States or Canada, and the Reinsurer's share exceeds $1,000,000; or
c) The claim is one for which there is no body, i.e. the insured is missing and presumed dead, and the Reinsurer's share exceeds $0. If the Reinsurer discovers that the Company's claims paying practices and procedures differ materially from those performed at the inception of the Agreement or from the Business Guidelines, then, in addition to any other remedies, the Reinsurer may, with 30 days' written notice, adjust the threshold amounts specified above.
Conditions Requiring Claims Consultation. Before conceding liability or making settlement to the claimant, the Company will seek the Reinsurer’s recommendation if:
a) The claim occurs during the contestable period and the Company is not contesting the claim, but the Reinsurer’s share exceeds $1,000,000; or
b) The death occurs outside of the United States or Canada, and the Reinsurer’s share exceeds $1,000,000; or
a) The claim is one for which there is no body, i.e. the insured is missing and presumed dead, and the Reinsurer’s share exceeds $0; or
b) The Company does not obtain a certified death certificate. If the Reinsurer discovers that the Company’s claims paying practices and procedures differ materially from those performed at the inception of the Agreement or from the Business Guidelines, then, in addition to any other remedies, the Reinsurer may, with 30 days’ written notice, adjust the threshold amounts specified above.
Conditions Requiring Claims Consultation. Before conceding liability or making settlement to the claimant, the Company will seek the Reinsurer’s recommendation if:
a) The claim occurs during the contestable period; or
b) The claim occurs outside of the United States or Canada; or
c) The claim is one for which there is no body, i.e. the insured is missing and presumed dead. If the Reinsurer discovers that the Company’s claims paying practices and procedures differ materially from those performed at the inception of the Agreement or from the Business Guidelines, then, in addition to any other remedies, the Reinsurer may, with 30 days’ written notice, adjust the threshold amounts specified above.
Conditions Requiring Claims Consultation. Before conceding liability or making settlement to the claimant, the Company will seek the Reinsurer’s recommendation if:
a) The claim occurs during the contestable period and the Company is contesting the claim; or
b) The claim occurs during the contestable period and the Company kept its retention at the time of issue and it is not contesting the claim; or
c) The claim occurs outside of the United States or Canada; or
d) The claim is one for which there is no body, i.e. the insured is missing and presumed dead, or
e) The claim is one for which there is reasonable doubt as to the authenticity of the death certificate or the reliability of the medical report concerning such death. If the Reinsurer discovers that the Company’s claims paying practices and procedures differ materially from those performed at the inception of the Agreement or from the Business Guidelines, then, in addition to any other remedies, the Reinsurer may, with 30 days’ written notice, adjust the threshold amounts specified above.
Conditions Requiring Claims Consultation. Before conceding liability or making settlement to the claimant, the Company will seek the Reinsurer’s recommendation if:
Conditions Requiring Claims Consultation. For purposes of this provision, “retention” will refer to the limits specified in the appropriate Exhibit D in effect at the time of policy issue. Before conceding liability or making settlement to the claimant, the Company will seek the Reinsurer’s recommendation if:
a) The claim occurs during the contestable period and the Company is contesting the claim, or
b) The claim occurs during the contestable period and the Company kept its retention at the time of issue and it is not contesting the claim, but the face amount per life exceeds $0, or
c) The claim occurs outside of the contestable period and the Company kept its retention at the time of issue and it is not contesting the claim, but the face amount per life exceeds $500,000, or
d) The claim occurs outside of the United States or Canada, and the face amount per life exceeds $0, or
e) The claim is one for which there is no body, i.e. the insured is missing and presumed dead, or
f) The claim is one for which there is reasonable doubt as to the authenticity of the death certificate or the reliability of the medical report concerning such death or
g) The claim is for accelerated death benefits. If the Reinsurer discovers that the Company’s claims paying practices and procedures differ materially from those performed at the inception of the Agreement or from the Business Guidelines, then, in addition to any other remedies, the Reinsurer may, with 30 days’ written notice, adjust the threshold amounts specified above.
Conditions Requiring Claims Consultation. Before conceding liability or making settlement to the claimant, the Ceding Company will seek the Reinsurer's recommendation if:
a) The claim occurs during the contestable period and the Ceding Company is not contesting the claim, but the Reinsurer's share exceeds $0, or
b) The claim occurs outside of the United States or Canada, and the Reinsurer's share exceeds $0, or
c) The claim is one for which there is no body, i.e. the insured is missing and presumed dead, and the Reinsurer's share exceeds $0. If the Reinsurer discovers that the Ceding Company's claims paying practices and procedures differ materially from those performed at the inception of the Agreement or from the Business Guidelines, then, in addition to any other remedies, the Reinsurer may, with 30 days' written notice, adjust the threshold amounts specified above. Premium rates for conversions to plans not covered by an existing agreement with the Reinsurer shall be the same as the rates defined in Exhibit E of this agreement.
Conditions Requiring Claims Consultation. For purposes of this provision, "retention" will refer to the limits specified in the appropriate Exhibit 0 in effect at the time of policy issue. Before conceding liability or making settlement to the claimant. the Company will seek the Reinsurer's recommendation if:
a) The claim occurs during the contestable period and the Company is contesting the claim. or
Conditions Requiring Claims Consultation. Before conceding liability or making settlement to the claimant, the Ceding Company will seek the Reinsurer's recommendation if:
a) The claim occurs during the contestable period and the Ceding Company is not contesting the claim, but the Reinsurer's share exceeds $0, or
b) The claim occurs outside of the United States or Canada, and the Reinsurer's share exceeds $0, or
c) The claim is one for which there is no body, i.e. the insured is missing and presumed dead, and the
