EXCLUSIONS−WHAT IS NOT COVERED Sample Clauses

EXCLUSIONS−WHAT IS NOT COVERED. The paragraph which begins with “If your Claim for benefits is denied...” of this section is hereby deleted in its entirety and replaced with the following: If your Claim for benefits is denied on the basis that the services or supplies were not Medically Neces- sary, and you disagree with Blue Cross and Blue Shield’s decision, your policy provides for an appeal of that decision. You must exercise your right to appeal as a precondition to the taking of any further action against Blue Cross and Blue Shield, either at law or in equity. To initiate your appeal, you must give Blue Cross and Blue Shield written notice of your intention to do so within 60 days after you have been notified that your Claim has been denied by writing to: Claim Review Section Blue Cross and Blue Shield Administrator: Hallmark Services Corp. P.O. Box 3235 Naperville, Illinois 60566-7235 You may furnish or submit any additional documentation which you or your Physician believe ap- propriate.
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Related to EXCLUSIONS−WHAT IS NOT COVERED

  • WHAT IS NOT COVERED (A) Products not originally covered by a manufacturer’s warranty; (B) Products with less than an original ninety (90) days manufacturer’s parts and labor limited warranty (C) Product repairs that should be covered by the manufacturer’s warranty or are a result of a recall, regardless of the manufacturer’s ability to pay for such repairs; (D) Cleaning; Periodic checkups; preventive maintenance; (E) Any and all pre-existing conditions that occur prior to the effective date of this Agreement and/or any product sold used or “AS-IS”, including but not limited to floor models, demonstrations models, etc.; (F) Part or repairs due to normal wear and tear unless tied to a breakdown, and items normally designed to be periodically replaced by You during the life of the product, including but not limited to batteries, light bulbs, etc.; (G) Damage from abuse, misuse, mishandling, introduction of foreign objects into the Covered Product, unauthorized modifications or alterations to a Covered Product; failure to follow the manufacturer’s instructions for operation and care of the Covered Product; external causes of any kind, including third party actions; fire; theft; insects; animals; exposure to weather; windstorm; sand; dirt; hail; earthquake; flood; water; acts of God or consequential loss of any nature; (H) Loss or damage caused by invasion; rebellion; riot; strike; labor disturbance; lockout; or civil commotion; (I) Incidental, consequential or secondary damages or delay in rendering service under this Agreement; loss of use during the period that the Covered Product is at an authorized service center or awaiting parts; (J) Any product used in a commercial setting or rental basis unless You purchased a Commercial Coverage Plan; (K) Failures that occur outside of the 50 states of the United States of America and the District of Columbia; (L) Non-functional or aesthetic parts including but not limited to frames, cabinets, doors, hinges, plastic parts, knobs, rollers, baskets; scratches, peeling & dents; (M) Unauthorized repairs and/or parts; (N) Cost of installation, setup, diagnostic charges, of the Covered Product, except as provided herein; (O) Accessories used in conjunction with a Covered Product including remote controls; (P) Any other loss other than a covered breakdown; (Q) Service where no problem can be found; noises; squeaks; breakdowns which are not reported during the term of this Agreement; (R) any breakdown or condition that results from abnormal usage of the Covered Product; (S) coin mechanisms.

  • WHAT IS COVERED 1. Mechanical & Electrical failures

  • MATTERS NOT COVERED 35.1 The parties agree that by mutual consent they will consult and negotiate on matters not covered by this Agreement, which are proper subjects for collective bargaining.

  • Examples of Items/Conditions Not Covered Any gas service lines in excess of 500 feet in length; high pressure gas lines and the high pressure service line which is defined as a natural gas supply line with a pressure rating of 60 psi or greater; natural gas meter including connections; appliances or appliance connectors or burner tips; any gas service line not measuring between ½” and 1 ¼” in diameter; utility meters; any interior gas piping. EXTGAS 07/14

  • DISCLAIMERS; EXCLUSIONS; LIMITATIONS Subject to §4, neither party makes any warranties (express, implied, or otherwise), including implied warranties of merchantability, non-infringement, fitness for a particular purpose, or title, related to its performance or anything else provided under this Agreement. Neither party will be liable for any special, incidental, punitive, or consequential damages of any kind for any reason whatsoever relating to this Agreement, even if such damages were reasonably foreseeable.

  • COVERED NOT COVERED All components and parts of well pump utilized as a source of water to the home. Above or underground piping, cable or electrical lines leading to or from the well pump, including those that are located within the well casing, well casings, pressure switches not located on the pump, holding, storage or pressure tanks, booster pumps, re-drilling of xxxxx, well pump and all well pump components for geothermal and/or water source heat pumps. NOTE: We will pay up to $1,500 per Agreement term for access, diagnosis and repair or replacement.

  • Commercial General Liability and Business Auto Liability will be endorsed to provide primary and non-contributory coverage The Commercial General Liability Additional Insured endorsement will include on-going and completed operations and will be submitted with the

  • High Risk Use Npcap is not designed, manufactured, or intended for use in hazardous environments requiring fail-safe performance where the failure of the software could lead directly to death, personal injury, or significant physical or environmental damage (“High Risk Activities”). Use of Npcap in High Risk Activities is not authorized.

  • Windstorm or hail This peril does not include loss to the property contained in a building caused by rain, snow, sleet, sand or dust unless the direct force of wind or hail damages the building causing an opening in a roof or wall and the rain, snow, sleet, sand or dust enters through this opening. This peril includes loss to watercraft and their trailers, furnishings, equipment, and outboard engines or motors, only while inside a fully enclosed building.

  • EXEMPT AND SAVE HARMLESS The Employer shall insure to: A) exempt and save harmless employees from any liability action arising from the proper performance of her duties for the Employer, and B) assume all costs, legal fees and other expenses arising from any such action.

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