Common use of Denials Clause in Contracts

Denials. A claim denial, also known as an adverse benefit determination, is any of the following: • a full or partial denial of a benefit; • a reduction of a benefit; • a termination of a benefit; • a failure to provide or make a full or partial payment for a benefit; and • a rescission of coverage, even if there is no adverse effect on any benefit.

Denials. A claim denial, also known as an adverse benefit determination, is any of the following: •  a full or partial denial of a benefit; •  a reduction of a benefit; •  a termination of a benefit; •  a failure to provide or make a full or partial payment for a benefit; and •  a rescission of coverage, even if there is no adverse effect on any benefit.