Common use of GRIEVANCE AND APPEALS Clause in Contracts

GRIEVANCE AND APPEALS. This section outlines the procedures for and the time periods applicable to grievances and appeals. The Insured, the Insured’s authorized representative, or Physician or health care provider has the right to file a Grievance, file an appeal, and have an External review. It is the policy of this Company to provide Insureds with a full and fair review of grievance and appeal decisions.