PARTY, PRIMARY, OR OTHER INSURANCE COVERED CLAIMS Sample Clauses

PARTY, PRIMARY, OR OTHER INSURANCE COVERED CLAIMS. 2 A. Reimbursement provided through the Agreement shall be payment of last resort. Prior to 3 submitting any claim to CONTRACTOR for reimbursement of Medical Services provided to an 4 Enrollee, All Providers shall: 5 1. Use their reasonable best efforts to determine whether the claim is a third-party or primary 6 other insurance covered claim. 7 2. Xxxx and use their reasonable best efforts to collect third-party or primary other insurance 8 covered claims to the full extent of such coverage. 9 B. All Providers shall determine that a claim is not covered, in whole or in part, under any other 10 state or federal medical care program or under any other contractual or legal entitlement including, but 11 not limited to, coverage defined in W&I Section 10020. 12 C. With submission of a claim, All Providers shall provide proof of denial to CONTRACTOR, if a 13 third-party or primary other insurance denies coverage of the claim. 14 D. All Providers shall report to CONTRACTOR any payments received from third-party or 15 primary other insurance covered claims. 16 E. The Agreement shall not allow for reimbursement of deductibles and co-payments required by 17 an Enrollee’s primary other insurance coverage. 18 F. All Providers shall provide CONTRACTOR such records and other documentation as 19 CONTRACTOR may reasonably require to maintain centralized data collection and referral services in 20 support of third-party revenue recovery activities.
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Related to PARTY, PRIMARY, OR OTHER INSURANCE COVERED CLAIMS

  • PROFESSIONAL LIABILITY AND CYBER LIABILITY INSURANCE COVERAGE In addition to the insurance required in Attachment C to this Contract, before commencing work on this Contract and throughout the term of this Contract, Contractor agrees to procure and maintain (a) Technology Professional Liability insurance for any and all services performed under this Contract, with minimum third party coverage of $1,000,000.00 per claim, $2,000,000.00 aggregate. To the extent Contractor has access to, processes, handles, collects, transmits, stores or otherwise deals with State Data, Contractor shall maintain first party Breach Notification Coverage of not less than $1,000,000.00. Before commencing work on this Contract the Contractor must provide certificates of insurance to show that the foregoing minimum coverages are in effect. With respect to the first party Breach Notification Coverage, Contractor shall name the State of Vermont and its officers and employees as additional insureds for liability arising out of this Contract.

  • Professional Indemnity Insurance A policy of insurance to cover claims made against the insured for: civil liability for breach of professional duty (whether owed in contract or otherwise); and unintentional breaches of third party intellectual property, by the Contractor or its subcontractors in carrying out the Contractor's Activities.

  • Qualifying Insurers For insurance to satisfy the requirements of this section, all required insurance must be issued by an insurer with an A.M. Best rating of A - or better that is approved to do business in the State of California.

  • Director and Officer Liability Insurance The Company will maintain an insurance policy or policies providing directors’ and officers’ liability insurance, and the Insiders shall be covered by such policy or policies, in accordance with its or their terms, to the maximum extent of the coverage available for any of the Company’s directors or officers.

  • Waiver of Subrogation, Reimbursement and Contribution Notwithstanding anything to the contrary contained in this Guaranty, Guarantor hereby unconditionally and irrevocably waives, releases and abrogates any and all rights it may now or hereafter have under any agreement, at law or in equity (including, without limitation, any law subrogating the Guarantor to the rights of Lender), to assert any claim against or seek contribution, indemnification or any other form of reimbursement from Borrower or any other party liable for payment of any or all of the Guaranteed Obligations for any payment made by Guarantor under or in connection with this Guaranty or otherwise.

  • Errors and Omissions, Professional Liability or Malpractice Insurance Contractor may be required to carry errors and omissions, professional liability or malpractice insurance. All policies shall remain in force through the life of this Contract and shall be payable on a "per occurrence" basis unless County specifically consents to a "claims made" basis. The insurer shall supply County adequate proof of insurance and/or a certificate of insurance evidencing coverages and limits prior to commencement of work. Should any of the required insurance policies in this Contract be cancelled or non-renewed, it is the Contractor’s duty to notify the County immediately upon receipt of the notice of cancellation or non-renewal. If Contractor does not carry a required insurance coverage and/or does not meet the required limits, the coverage limits and deductibles shall be set forth on a waiver, Exhibit C, attached hereto. Failure to provide and maintain the insurance required by this Contract will constitute a material breach of this Contract. In addition to any other available remedies, County may suspend payment to the Contractor for any services provided during any time that insurance was not in effect and until such time as the Contractor provides adequate evidence that Contractor has obtained the required coverage.

  • Deductibles and Self-Insured Retentions Any deductibles or self-insured retentions must be declared to, and approved by CITY's Risk Manager. At the option of CITY, either; the insurer shall reduce or eliminate such deductibles or self-insured retentions as respects CITY, its officer, employees, agents and contractors; or GRANTEE shall procure a bond guaranteeing payment of losses and related investigations, claim administration and defense expenses in an amount specified by the CITY's Risk Manager.

  • Professional Liability (Errors and Omissions) For consultant contracts, insurance appropriate to Consultant’s profession, with limit no less than $1,000,000 per occurrence or claim, $2,000,000 aggregate.

  • Professional Liability (Errors and Omissions) Insurance Limits shall not be less than the following: (a) For Projects with a budgeted construction cost of more than $30,000,000: i. For Design Professionals – $3,000,000 per claim and $4,000,000 in aggregate coverage; ii. For Subconsultant Engineers and Architects – $2,000,000 per claim and $3,000,000 in aggregate coverage; iii. For Other Consultants – $1,000,000 per claim and $2,000,000 in aggregate coverage. At the Design Professional’s request, the Owner may, at its sole discretion, agree to a lower limit for certain consultants. (b) For Projects with a budgeted construction cost of $20,000,000 up to $30,000,000: i. For Design Professionals – $2,000,000 per claim and $3,000,000 in aggregate coverage; ii. For Subconsultant Engineers and Architects – $1,000,000 per claim and $2,000,000 in aggregate coverage; iii. For Other Consultants – $1,000,000 per claim and $1,000,000 in aggregate coverage. At the Design Professional’s request, the Owner may, at its sole discretion, agree to a lower limit for certain consultants. (c) For Projects with a budgeted construction cost of less than $20,000,000: i. For Design Professionals – $1,000,000 per claim and $1,000,000 in aggregate coverage; ii. For Subconsultant Engineers and Architects – $1,000,000 per claim and $1,000,000 in aggregate coverage; iii. For Other Consultants – $1,000,000 per claim and $1,000,000 in aggregate coverage. At the Design Professional’s request, the Owner may, at its sole discretion, agree to a lower limit for certain consultants. (d) The Design Professional shall maintain professional liability insurance that shall be either a practice policy or project-specific coverage. Professional liability insurance shall contain prior acts coverage for services performed by the Design Professional for this Project. If project-specific coverage is used, these requirements shall be continued in effect for three years following the issuance of the Certificate of Final Completion for the Project.

  • Officer and Director Liability Insurance The Company shall, from time to time, make the good faith determination whether or not it is practicable for the Company to obtain and maintain a policy or policies of insurance with reputable insurance companies providing the officers and directors of the Company with coverage for losses from wrongful acts, or to ensure the Company’s performance of its indemnification obligations under this Agreement. Among other considerations, the Company will weigh the costs of obtaining such insurance coverage against the protection afforded by such coverage. In all policies of director and officer liability insurance, Indemnitee shall be named as an insured in such a manner as to provide Indemnitee the same rights and benefits as are accorded to the most favorably insured of the Company’s directors, if Indemnitee is a director; or of the Company’s officers, if Indemnitee is not a director of the Company but is an officer; or of the Company’s key employees, if Indemnitee is not an officer or director but is a key employee. Notwithstanding the foregoing, the Company shall have no obligation to obtain or maintain such insurance if the Company determines in good faith that such insurance is not reasonably available, if the premium costs for such insurance are disproportionate to the amount of coverage provided, if the coverage provided by such insurance is limited by exclusions so as to provide an insufficient benefit, or if Indemnitee is covered by similar insurance maintained by a parent or subsidiary of the Company.

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