Determination of Coverage Sample Clauses
The Determination of Coverage clause defines the process by which an insurer decides whether a particular claim or loss is covered under the terms of an insurance policy. Typically, this involves the insurer reviewing the facts of the claim, the policy language, and any relevant exclusions or conditions to assess if the event falls within the scope of coverage. For example, the insurer may require documentation or conduct an investigation before making a decision. This clause ensures clarity and transparency in how coverage decisions are made, helping to prevent disputes and manage expectations between the insurer and the insured.
Determination of Coverage. Subject to subsection 7(c) hereof, the Indemnifying Parties shall, from time to time obtain and maintain a policy or policies of insurance on terms and with coverage limits which provide the Indemnified Party with insurance coverage which is similar in all material respects to the trustees’, directors’, managers’, officers’ or other applicable liability insurance coverage now provided by the Indemnifying Parties to the Indemnified Party, the particulars of which are set out in Schedule A hereto, or coverage which provides enhanced overall insurance coverage to the Indemnified Party.
Determination of Coverage. The District reserves the right to withhold payment of any disability benefits until such time it is determined whether or not the illness or injury is covered by Workers’ Compensation.
Determination of Coverage. Any determination of coverage by Company shall be conclusive evidence that the matter is within the Title Policy coverage that is the subject of this Indemnity. Additionally, Company shall have the right, in its sole discretion, to determine for itself and the undersigned whether any claim, demand or suit brought against the title to the Land, or the estate or interest insured under the Title Policy, shall be paid, compromised, settled, tried, defended, or appealed, and its determination shall be final, binding, and conclusive upon the undersigned. The liability of the Indemnitor under this Indemnity is direct and primary and is not conditioned or contingent on prior pursuit of any remedies by Company. The Indemnitor shall be liable and shall promptly pay to Company all costs, expenses and attorneys’ fees incurred by Company in enforcing any of its rights hereunder. Company shall also have the right to select counsel of its choice to defend or prosecute any action on behalf of Company or its insured(s) under the Title Policy.
Determination of Coverage a) Eligible Covered Items are dependent on the Plan you purchase as identified in section VII. All Covered Items must comply with the following to be deemed covered in accordance with the terms and conditions of this Agreement:
i. Be in place, in proper and safe operating condition and installed properly, up to code, and maintained as required for the lifetime of the system or appliance on the Active Date of this Agreement. Preexisting conditions, whether known or unknown, will not be covered.
ii. Be located inside the confines of the main foundation of the home or attached garage (exceptions are Air Conditioner, Pool/Spa, Septic System and Well Pump).
iii. Become inoperable due to normal wear and tear.
b) The Covered Items must be deemed to have been in “proper operating condition” on the Agreement Active Date. Items must be correctly located within the home, fully connected, and capable of successfully performing all operations consistent with the manufacturer’s original design intention. Items cannot pose any hazard to life or property. Determination of the nature of any failure will be made by Capital Shield Home Services based upon our professional opinion, including but not limited to, diagnosis made by our authorized Service Providers or trained direct employees.
c) To determine coverage, CSHS will take into consideration any data collected for the purposes, of coming to an amicable resolution. This may include but may not be limited to the diagnosis provided by the Service Provider. Any determination of coverage will be made solely by CSHS.
d) You are responsible for following the manufacturer standards of your appliance(s) or system(s) with respect to Routine Maintenance.
Determination of Coverage a. If there has not been a Change in Control of the Company (as hereinafter defined), the Reviewing Party shall be (i) quorum of the Board of Directors consisting of directors who are not parties to the action, suit or proceeding acting by majority vote, or, (ii) if such a quorum is not obtainable, or, even if obtainable, a quorum of disinterested directors so directs, independent legal counsel by the use of a written opinion or (iii) the stockholders. If there has been a Change in Control of the Company, the Reviewing Party shall be the special, independent counsel referred to in Section 4 hereof.
b. If Indemnitee has not been indemnified by the expiration of the foregoing thirty-day period or received expense advances or if the Reviewing Party determines that Indemnitee would not be permitted to be indemnified or be entitled to receive expense advances within two days of the request therefor in whole or in part under applicable law, Indemnitee shall have the right to commence litigation seeking from the court a finding that Indemnitee is entitled to indemnification and expense advances or enforcement of Indemnitee’s entitlement to indemnification and expense advances or challenging any determination by the Reviewing Party or any aspect thereof that Indemnitee is not entitled to be indemnified or receive expense advances and the burden of proving that indemnification or advancement of expenses is not appropriate shall be on the Company; any determination by the Reviewing Party in favor of Indemnitee shall be conclusive and binding on the Company, unless facts supplied by Indemnitee which form the basis for the determination are subsequently determined to have been materially incorrect at the time supplied. Indemnitee agrees to bring any such litigation in any court in the States of Texas having subject matter jurisdiction thereof and in which venue is proper, and the Company hereby consents to service of process and to appear in any such proceeding.
c. The Company agrees that if there is a Change in Control of the Company (as hereinafter defined), then with respect to all matters thereafter arising concerning the rights of Indemnitee to indemnity payments and expense advances under this Agreement or any other agreement or By-laws now or hereafter in effect relating to Claims for Indemnifiable Events, the Company shall seek legal advice only from special, independent counsel selected by Indemnitee who a majority of the disinterested Directors approves (whi...
Determination of Coverage. United HealthCare Dental will decide if the Claim is based on an Emergency and if services were reasonably available from a Participating Dentist. If a Participant asks United HealthCare Dental to authorize Emergency services, United HealthCare Dental will grant or deny the request in no more than one hour. The Participant may ask the Texas Department of Insurance to review any denial. A Participant cannot reasonably get services from a Participating Dentist if he or she is more than 30 miles from the service area or if timely care is not available from a Participating Dentist. United HealthCare Dental will pay for Claims based on a real Emergency only if United HealthCare Dental would have paid for the service if the service had been provided by a Participating Dentist.
Determination of Coverage. The Corporation shall, from time to time:
(i) make a good faith determination of whether or not it is practicable for the Corporation to obtain and maintain a policy or policies of insurance with reputable insurance companies providing any or all of the Agents of the Corporation with coverage from losses from wrongful acts, insurable losses they may incur in their capacities as directors of the Corporation or to insure the Corporation’s performance of its indemnification obligations under this Agreement;
(ii) weigh the costs of obtaining such insurance coverage against the protection afforded by such coverage; and
(iii) subject to section 8(3) hereof (and whether or not the Director continues to be a director of the Corporation), obtain and maintain a policy or policies of insurance on terms and with coverage limits which provide the Director with insurance coverage which is similar in all material respects to the directors’ and officers’ insurance coverage now provided by the Corporation to the Director, the particulars of which have been provided to the Director, or coverage which provides enhanced overall directors’ and officers’ insurance coverage to the Director.
Determination of Coverage. Indemnitor unequivocally agrees and understands that (a) any determination of coverage by Company shall be conclusive evidence that the matter is within the Title Policy coverage that is the subject of this Indemnity, (b) Company shall have the right, in its sole discretion, to determine for itself and the undersigned whether any claim, demand or suit brought against the title to the Land or the estate or interest insured under the Title Policy, shall be paid, compromised, settled, tried, defended or appealed, and its determination shall be final, binding and conclusive upon the undersigned, and (c) Company shall also have the right to select counsel of its choice to defend or prosecute any action on behalf of Company or its insured(s) under the Title Policy. The liability of the Indemnitor under this Indemnity is direct and primary and is not conditioned or contingent on prior pursuit of any remedies by Company. The Indemnitor shall be liable and shall promptly pay to Company all costs, expenses and attorneys’ fees incurred by Company in enforcing any of its rights hereunder.