Common use of Notice of Denial Clause in Contracts

Notice of Denial. The notice of denial to the Claimant shall state: (1) The specific reasons for the denial. (2) Specific references to pertinent provisions of the Agreement on which the denial was based. (3) A description of any additional material or information needed for Employee to perfect his claim and an explanation of why the material or information is needed. (4) A statement that Employee may request a review upon written application to the Administrator, review pertinent documents, and submit issues and comments in writing and that any appeal that Employee wishes to make of the adverse determination must be in writing to the Administrator within 60 days after Employee receives notice of denial of benefits. (5) The name and address of the Administrator to which Employee may forward an appeal. The notice may state that failure to appeal the action to the Administrator in writing within the 60-day period will render the determination final, binding and conclusive.

Notice of Denial. The notice of denial to the Claimant shall state: (1) The specific reasons for the denial. (2) Specific references to pertinent provisions of the Agreement on which the denial was based. (3) A description of any additional material or information needed for Employee to perfect his claim and an explanation of why the material or information is needed. (4) A statement that Employee may request a review upon written application to the Administrator, review pertinent documents, and submit issues and comments in writing and that any appeal that Employee wishes to make of the adverse determination must be in writing to the Administrator within 60 days after Employee receives notice of denial of benefits. (5) The name and address of the Administrator to which Employee may forward an appeal. The notice may state that failure to appeal the action to the Administrator in writing within the 60-day 60‑day period will render the determination final, binding and conclusive.