Common use of Notice and Proof of Claim Clause in Contracts

Notice and Proof of Claim. Written notice of each Illness or Injury for which benefits are claimed should be given to SHL within twenty (20) days of the date any healthcare services are received. Failure to furnish notice within twenty (20) days will not invalidate or reduce any claim if it is shown that notice was provided as soon as was reasonably possible. SHL, upon receipt of such notice, will furnish to the Insured within fifteen (15) days forms for filing the proof of claim. If such forms are not furnished within fifteen (15) days, the Insured shall be deemed to have complied with the requirements of this Plan as to proof of loss upon submitting, within fifteen (15) days, written proof covering the occurrence, the character and the extent of the loss for which the claim is being made. SHL agrees to: (a) Provide claim forms to the Insured for submitting claims to SHL; (b) Receive claims and claims documentation; (c) Correspond with Insureds and Providers of services if additional information is deemed by SHL to be necessary to complete the processing of claims; (d) Coordinate benefits payable under the Plan with other benefit plans, if any; (e) Determine the amount of benefits payable under the Plan; and (f) Pay the amount of benefits determined to be payable under the Plan. When seeking reimbursement from SHL for expenses incurred in connection with services received, the Insured must complete a claim form and submit it to the SHL Claims Department with copies of all of the medical records, bills and/or receipts from the Provider. Additional claim forms can be obtained by calling the Member Services Department at 000-000-0000. If the Insured receives a xxxx for Covered Services, the Insured may request that SHL pay the Provider directly by sending the xxxx, with copies of all medical records and a signed completed claim form to the SHL Claims Department. SHL shall approve or deny a claim within thirty (30) days after receipt of the claim. If the claim is approved, the claim shall be paid within thirty (30) days from the date it was approved.

Notice and Proof of Claim. Written notice of each Illness or Injury for which benefits are claimed should be given to SHL within twenty (20) days of the date any healthcare services are received. Failure to furnish notice within twenty (20) days will not invalidate or reduce any claim if it is shown that notice was provided as soon as was reasonably possible. SHL, upon receipt of such notice, will furnish to the Insured within fifteen (15) days forms for filing the proof of claim. If such forms are not furnished within fifteen (15) days, the Insured shall be deemed to have complied with the requirements of this Plan as to proof of loss upon submitting, within fifteen (15) days, written proof covering the occurrence, the character and the extent of the loss for which the claim is being made. SHL agrees to: (a) Provide claim forms to the Insured for submitting claims to SHL; (b) Receive claims and claims documentation; (c) Correspond with Insureds and Providers of services if additional information is deemed by SHL to be necessary to complete the processing of claims; (d) Coordinate benefits payable under the Plan with other benefit plans, if any; (e) Determine the amount of benefits payable under the Plan; and (f) Pay the amount of benefits determined to be payable under the Plan. When seeking reimbursement from SHL for expenses incurred in connection with services received, the Insured must complete a claim form and submit it to the SHL Claims Department with copies of all of the medical records, bills and/or receipts from the Provider. Additional claim forms can be obtained by calling the Member Services Department at 000-000-0000. If the Insured receives a xxxx for Covered Services, the Insured may request that SHL pay the Provider directly by sending the xxxx, with copies of all medical records and a signed completed claim form to the SHL Claims Department. SHL shall approve or deny a claim within thirty (30) days after receipt of the claim. If the claim is approved, the claim shall be paid within thirty (30) days from the date it was approved.. If the approved claim is not paid within that thirty (30) day period, SHL shall pay interest on the claim at the rate set forth by applicable Nevada law. The interest will be calculated from thirty (30) days after the date on which the claim is approved until the date upon which the claim is paid. SHL may request additional information to determine whether to approve or deny the claim. SHL shall notify the Provider of its request for additional information within twenty (20) days after receipt of the claim. SHL will notify the Provider of the healthcare services of all the specific reasons for the delay in approving or denying the claim. SHL shall approve or deny the claim within thirty

Notice and Proof of Claim. Written notice of each Illness or Injury for which benefits are claimed should be given to SHL within twenty (20) days of the date any healthcare services are received. Failure to furnish notice within twenty (20) days will not invalidate or reduce any claim if it is shown that notice was provided as soon as was reasonably possible. SHL, upon receipt of such notice, will furnish to the Insured within fifteen (15) days forms for filing the proof of claim. If such forms are not furnished within fifteen (15) days, the Insured shall be deemed to have complied with the requirements of this Plan as to proof of loss upon submitting, within fifteen (15) days, written proof covering the occurrence, the character and the extent of the loss for which the claim is being made. SHL agrees to: (a) Provide claim forms to the Insured for submitting claims to SHL; (b) Receive claims and claims documentation; (c) Correspond with Insureds and Providers of services if additional information is deemed by SHL to be necessary to complete the processing of claims; (d) Coordinate benefits payable under the Plan with other benefit plans, if any; (e) Determine the amount of benefits payable under the Plan; and (f) Pay the amount of benefits determined to be payable under the Plan. When seeking reimbursement from SHL for expenses incurred in connection with services received, the Insured must complete a claim form and submit it to the SHL Claims Department with copies of all of the medical records, bills and/or receipts from the Provider. Additional claim forms can be obtained by calling contacting the Member Services Department at (000) 000-0000 or 1- 000-000-0000. If the Insured receives a xxxx for Covered Services, the Insured may request that SHL pay the Provider directly by sending the xxxx, with copies of all medical records and a signed completed claim form to the SHL Claims Department. SHL shall approve or deny a claim within thirty (30) days after receipt of the claim. If the claim is approved, the claim shall be paid within thirty (30) days from the date it was approved. If the approved claim is not paid within that thirty (30) day period, SHL shall pay interest on the claim at the rate set forth by applicable Nevada law. The interest will be calculated from thirty (30) days after the date on which the claim is approved until the date upon which the claim is paid. SHL may request additional information to determine whether to approve or deny the claim. SHL shall notify the Provider of its request for additional information within twenty (20) days after receipt of the claim. SHL will notify the Provider of the healthcare services of all the specific reasons for the delay in approving or denying the claim. SHL shall approve or deny the claim within thirty (30) days after receiving the additional information. If the claim is approved, SHL shall pay the claim within thirty (30) days after it receives the additional information. If the approved claim is not paid within that time period, SHL shall pay interest on the claim in the manner set forth above. If SHL denies the claim, notice to the Insured will include the reasons for the rejection and the Insureds right to file an Informal Appeal as set forth in the Appeals Procedures section of this AOC.

Notice and Proof of Claim. Written notice of each Illness or Injury for which benefits are claimed should be given to SHL within twenty (20) days of the date any healthcare services are received. Failure to furnish notice within twenty (20) days will not invalidate or reduce any claim if it is shown that notice was provided as soon as was reasonably possible. SHL, upon receipt of such notice, will furnish to the Insured within fifteen (15) days forms for filing the proof of claim. If such forms are not furnished within fifteen (15) days, the Insured shall be deemed to have complied with the requirements of this Plan as to proof of loss upon submitting, within fifteen (15) days, written proof covering the occurrence, the character and the extent of the loss for which the claim is being made. SHL agrees to: (a) Provide claim forms to the Insured for submitting claims to SHL; (b) Receive claims and claims documentation; (c) Correspond with Insureds and Providers of services if additional information is deemed by SHL to be necessary to complete the processing of claims; (d) Coordinate benefits payable under the Plan with other benefit plans, if any; (e) Determine the amount of benefits payable under the Plan; and (f) Pay the amount of benefits determined to be payable under the Plan. When seeking reimbursement from SHL for expenses incurred in connection with services received, the Insured must complete a claim form and submit it to the SHL Claims Department with copies of all of the medical records, bills and/or receipts from the Provider. Additional claim forms can be obtained by calling contacting the Member Services Department at 0-000-000-0000. If the Insured receives a xxxx for Covered Services, the Insured may request that SHL pay the Provider directly by sending the xxxx, with copies of all medical records and a signed completed claim form to the SHL Claims Department. SHL shall approve or deny a claim within thirty (30) days after receipt of the claim. If the claim is approved, the claim shall be paid within thirty (30) days from the date it was approved. If the approved claim is not paid within that thirty (30) day period, SHL shall pay interest on the claim at the rate set forth by applicable Nevada law. The interest will be calculated from thirty (30) days after the date on which the claim is approved until the date upon which the claim is paid. SHL may request additional information to determine whether to approve or deny the claim. SHL shall notify the Provider of its request for additional information within twenty (20) days after receipt of the claim. SHL will notify the Provider of the healthcare services of all the specific reasons for the delay in approving or denying the claim. SHL shall approve or deny the claim within thirty (30) days after receiving the additional information. If the claim is approved, SHL shall pay the claim within thirty (30) days after it receives the additional information. If the approved claim is not paid within that time period, SHL shall pay interest on the claim in the manner set forth above. If SHL denies the claim, notice to the Insured will include the reasons for the rejection and the Insureds right to file an Informal Appeal as set forth in the Appeals Procedures section of this AOC.

Notice and Proof of Claim. Written notice of each Illness or Injury for which benefits are claimed should be given to SHL within twenty (20) days of the date any healthcare services are received. Failure to furnish notice within twenty (20) days will not invalidate or reduce any claim if it is shown that notice was provided as soon as was reasonably possible. SHL, upon receipt of such notice, will furnish to the Insured within fifteen (15) days forms for filing the proof of claim. If such forms are not furnished within fifteen (15) days, the Insured shall be deemed to have complied with the requirements of this Plan as to proof of loss upon submitting, within fifteen (15) days, written proof covering the occurrence, the character and the extent of the loss for which the claim is being made. SHL agrees to: (a) Provide claim forms to the Insured for submitting claims to SHL; (b) Receive claims and claims documentation; (c) Correspond with Insureds and Providers of services if additional information is deemed by SHL to be necessary to complete the processing of claims; (d) Coordinate benefits payable under the Plan with other benefit plans, if any; (e) Determine the amount of benefits payable under the Plan; and (f) Pay the amount of benefits determined to be payable under the Plan. When seeking reimbursement from SHL for expenses incurred in connection with services received, the Insured must complete a claim form and submit it to the SHL Claims Department with copies of all of the medical records, bills and/or receipts from the Provider. Additional Form No. SHL-Ind_AOC(2015) Page 26 claim forms can be obtained by calling contacting the Member Services Department at (000) 000-0000000 or 1-0000800-888- 2264. If the Insured receives a xxxx for Covered Services, the Insured may request that SHL pay the Provider directly by sending the xxxx, with copies of all medical records and a signed completed claim form to the SHL Claims Department. SHL shall approve or deny a claim within thirty (30) days after receipt of the claim. If the claim is approved, the claim shall be paid within thirty (30) days from the date it was approved. If the approved claim is not paid within that thirty (30) day period, SHL shall pay interest on the claim at the rate set forth by applicable Nevada law. The interest will be calculated from thirty (30) days after the date on which the claim is approved until the date upon which the claim is paid. SHL may request additional information to determine whether to approve or deny the claim. SHL shall notify the Provider of its request for additional information within twenty (20) days after receipt of the claim. SHL will notify the Provider of the healthcare services of all the specific reasons for the delay in approving or denying the claim. SHL shall approve or deny the claim within thirty (30) days after receiving the additional information. If the claim is approved, SHL shall pay the claim within thirty (30) days after it receives the additional information. If the approved claim is not paid within that time period, SHL shall pay interest on the claim in the manner set forth above. If SHL denies the claim, notice to the Insured will include the reasons for the rejection and the Insureds right to file an Informal Appeal as set forth in the Appeals Procedures section of this AOC. All claims must be submitted to SHL within sixty (60) days from the date expenses were incurred, unless it shall be shown not to have been reasonably possible to give notice within the time limit, and that notice was furnished as soon as was reasonably possible. If the Insured authorizes payment directly to the Provider, a check will be mailed to that Provider. A check will be mailed directly to the Insured if direct payment to the Provider is not authorized. The Insured will receive an explanation of how the payment was determined.