Emergency Claims Sample Clauses

Emergency Claims. If Emergency Services outside of the Service Area were re- ceived and expenses were incurred by the Member, the Mem- ber must submit a complete claim with the Emergency Service record (a copy of the Dentist’s bill) for payment to a contracted Dental Plan Administrator, within one (1) year af- ter the treatment date. Please send this information to: Blue Shield of California P. O. Box 272590 Xxxxx, CA 95927-2590 If the claim is not submitted within this period, the Plan will not pay for those Emergency Services, unless the claim was submitted as soon as reasonably possible as determined by the Plan. If the services are not pre-authorized, a contracted Den- tal Plan Administrator will review the claim retrospectively. If a contracted Dental Plan Administrator determines that the services were not Emergency Services and would not other- wise have been authorized by a contracted Dental Plan Ad- ministrator, and therefore, are not Covered Services under this Agreement, it will notify the Member of that determination. The Member is responsible for the payment of such Dental Care Services received. A contracted Dental Plan Adminis- trator will notify the Member of its determination within 30 days from receipt of the claim. If the Member disagrees with a contracted Dental Plan Administrator’s decision, the Mem- ber may appeal using the procedures outlined in the section entitled Member Services and Grievance Process.
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Emergency Claims. In the event of an emergency, in order for Select to make a determination if the system and/or appliance causing the emergency is covered under this Agreement, You must contact Select prior to having the repair ment work performed. In the event the emergency pertains to gas, fire or has the potential to cause injury to You or anyone else present in or near your home, you should take all reasonable steps, including, but not limited to, vacating the premises and contacting the proper authority to ensure the safety of You and those present. Once the determination is made by the proper authority that your home is safe to re-inhabit, You must contact Select immediately and advise them of this claim.
Emergency Claims. If Emergency Services outside of the Service Area were re- ceived and expenses were incurred by the Member, the Mem- ber must submit a complete claim with the Emergency Service record (a copy of the Dentist’s bill) for payment to a Plan Ad- ministrator, within 1 year after the treatment date. Please send this information to: P.O. Box 30567 If the claim is not submitted within this period, the Plan will not pay for those Emergency Services, unless the claim was submitted as soon as reasonably possible as determined by the Plan. If the services are not pre-authorized, a Dental Plan Ad- ministrator will review the claim retrospectively. If a Dental Plan Administrator determines that the services were not Emer- gency Services and would not otherwise have been authorized by a Dental Plan Administrator, and therefore, are not Covered Services under this Agreement, it will notify the Member of that determination. The Member is responsible for the payment of such Dental Care Services received. A Dental Plan Admin- istrator will notify the Member of its determination within 30 days from receipt of the claim. If the Member disagrees with a Dental Plan Administrator’s decision, the Member may appeal using the procedures outlined in the section entitled “Member Services and Grievance Process”. Blue Shield’s internet site is located at xxxx://xxx.xxxxxxxxxxxx.xxx. Members using a personal com- puter and modem with World Wide Web access may view and download healthcare information and software.
Emergency Claims. In the event of an emergency, in order for Select to make a determination if the system and/or appliance causing the emergency is covered under this Agreement, You must contact Select prior to

Related to Emergency Claims

  • Emergency Calls IP Phones need an additional power supply to operate. In the event of a power failure it is your responsibility to ensure you have the means to make emergency calls. In accordance with paragraph 13.2, we will not be liable for any loss or damage (financial or otherwise) where you fail to do so.

  • Emergency Closure Where there is a temporary closure as a result of an immediate emergency or a planned temporary closure due to renovations, repairs, or moves, the Employer will: a) First offer to the affected employees the choice of taking either a vacation day or an unpaid leave of absence with no loss of seniority or benefits; thereafter, at the Employer's discretion, one of the following: b) Reassign staff to another location; c) Reschedule the lost hours within two (2) pay periods; or d) Decide not to do either (b) or (c), in which case employees shall still be paid for their regularly scheduled hours which they did not work as a result of the temporary layoff.

  • Emergency Call-In When an employee is called in to perform unanticipated extra work, and the work is not an extension of his normal workday, he shall be compensated for the hours worked. Such compensation shall be for a minimum of four (4) hours in the event the employee works less than this amount of time. However, actual time worked will be considered for the computation of overtime.

  • Emergency Care If you need emergency care, call 911 or go to the nearest hospital emergency room. If you are traveling outside our service area and need urgent care, call the Customer Service number provided in the chart above or visit our website and use the “Find A Doctor” feature to find a BlueCard provider.

  • Emergency Closing 1. Management shall decide when, if and to what extent State facilities shall remain open or closed during emergencies, such as adverse weather conditions, acts of God, equipment breakdown, inoperable bathroom facilities, extreme office temperatures, etc. 2. The State shall designate one (1) person in each district area who will be responsible to call the Secretary of Administration or his/her designee if office, weather or other conditions exist which suggest closing is appropriate. 3. In facilities that must remain in operation despite emergency conditions, continued operations with a reduced work force may be authorized. In such instances, employees who are authorized to leave work early may do so without loss of pay or benefits. Employees who are required to remain at work shall receive compensatory time at straight time rates. 4. An employee who is unable to report to work due to weather or other emergency conditions shall have the absence charged against accumulated compensatory time or annual leave, in that order. 5. If management authorizes the complete closing of a State office or facility for emergency reasons, employees who leave the workplace shall receive their regular pay for time they are out of the closed office. 6. Employees required by management to work during complete emergency closings under (5) above, shall receive hourly pay at straight time rates for the hours so worked. This payment will be in addition to the employee’s regular pay.

  • Emergency Closings In the event that any part of or all of a student day or teacher duty day is lost due to any emergency, the teacher shall perform duties on that day or any other day in lieu thereof as the School District shall determine if any. Emergency closings include, but are not limited to, closing schools due to a pandemic or other health issues and weather related closings.

  • Emergency Conditions “Emergency Condition” shall mean a condition or situation: (1) that in the judgment of the Party making the claim is imminently likely to endanger life or property; or (2) that, in the case of the Transmission Provider, is imminently likely (as determined in a non-discriminatory manner) to cause a material adverse effect on the security of, or damage to the Transmission System, the Transmission Owner’s Interconnection Facilities or the Transmission Systems of others to which the Transmission System is directly connected; or (3) that, in the case of the Interconnection Customer, is imminently likely (as determined in a non-discriminatory manner) to cause a material adverse effect on the security of, or damage to, the Small Generating Facility or the Interconnection Customer’s Interconnection Facilities. Under Emergency Conditions, the Transmission Owner may immediately suspend interconnection service and temporarily disconnect the Small Generating Facility. The Transmission Provider shall notify the Interconnection Customer promptly when it becomes aware of an Emergency Condition that may reasonably be expected to affect the Interconnection Customer’s operation of the Small Generating Facility. The Interconnection Customer shall notify the Transmission Provider promptly when it becomes aware of an Emergency Condition that may reasonably be expected to affect the Transmission Owner’s Transmission System or other Affected Systems. To the extent information is known, the notification shall describe the Emergency Condition, the extent of the damage or deficiency, the expected effect on the operation of both Parties’ facilities and operations, its anticipated duration, and the necessary corrective action.

  • Emergency Situations If the condition is an emergency, this will be communicated to the Contractor with the request that corrections are to be accomplished immediately. The Contractor shall respond to the notice in emergency situations within twenty-four hours. If the Contractor fails to respond within this time limit, the Owner may correct the defect and charge the Contractor for the Work. If it is determined the complaint is not the responsibility of the Contractor, the Contractor shall be promptly paid for the cost of the corrective work. The Contractor shall give notice in writing to the Owner when corrections have been completed.

  • Emergency Work Employees who are required to report for emergency work on non- workdays, or outside of their regular hours of work on a scheduled workday or on holidays which they are entitled to have off, shall be paid overtime compensation for the actual work time and for travel time in connection therewith, but such travel time shall not exceed one-half (1/2) hour.

  • Emergency Thresholds The following matrix presents the emergency thresholds that, if reached by any of the services mentioned above for a TLD, would cause the emergency transition of the Registry for the TLD as specified in Section 2.13 of this Agreement. DNS Service (all servers) 4-hour total downtime / week DNSSEC proper resolution 4-hour total downtime / week EPP 24-hour total downtime / week RDDS (WHOIS/Web-based WHOIS) 24-hour total downtime / week Data Escrow Breach of the Registry Agreement as described in Specification 2, Part B, Section 6.

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