Handling of the Claims Sample Clauses

Handling of the Claims. If the Insured wants to make a claim on the Insurance, he/she must notify the Insurance Company in writing in advance. The Insurance Company shall issue the compensation decision. The Insurance Company has a right to appoint or approve the handler of the damage or compensation matters. The Insurance Company shall establish if the Insured is liable for a reported Insured Incident covered by the Insurance and negotiates with the party claiming compensation. If the Insured compensates the loss, agrees on this or accepts a claim, this is not binding to the Insurance Company, unless the amount and grounds of the compensation are obviously correct. The Insured must immediately notify the Insurance Company if the Insured Incident results in a court hearing. The Insurance Company shall take care of the court case and pay any legal costs arising from it within the limits of the amount Insured. If the court case also involves other matters, only the share of the claim covered by the Insurance in the costs is covered. If the Insurance Company has informed the Insured that it is prepared to agree on compensating the losses of the injured party within the limits of the amount Insured but the Insured does not accept this, the Insurance Company shall not be liable to compensate any costs subsequently incurred or to proceed to further investigations in the matter. The damage caused by a single act, act of negligence or condition shall be regarded as a single Insured Incident. This shall apply regardless of whether the damage was discovered over one or several insurance periods. If damage of this nature is discovered during separate insurance periods, they shall be regarded as concerning the insurance period during which the first damage was detected.
Sample 1
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Related to Handling of the Claims

  • Post Service Claims In the case of a Post-Service Claim, CareFirst BlueChoice shall notify the Member of the CareFirst BlueChoice’s Adverse Benefit Determination within a reasonable period of time, but not later than 30 days after receipt of the claim. This period may be extended one time by CareFirst BlueChoice for up to 15 days, provided that CareFirst BlueChoice both determines that such an extension is necessary due to matters beyond the control of CareFirst BlueChoice and notifies the Member, prior to the expiration of the initial 30-day period, of the circumstances requiring the extension of time and the date by which CareFirst BlueChoice expects to render a decision. If such an extension is necessary due to a failure of the Member to submit the information necessary to decide the claim, the notice of extension shall specifically describe the required information, and the Member shall be afforded at least 45 days from receipt of the notice within which to provide the specified information.

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