Procedure for Review of Denied Claims Sample Clauses

Procedure for Review of Denied Claims. If a claim for dependent group life insurance is denied, a notice will be sent explaining the reason for the denial. If there are any questions concerning the denial, inquiry should be made within 60 days from the date the claim was denied to the office that denied the claim, furnishing all information supporting the appeal. The appeal will be reviewed by that office and a reply made within 60 days after receipt of the appeal.
AutoNDA by SimpleDocs
Procedure for Review of Denied Claims. To afford employees a means by which they can seek review and possible reconsideration of a denied life, disability and health care claims, internal procedures of the Company and the Insurance Company will provide a procedure as indicated below. The termclaims processor” in Section H.3 means an entity contracting with the Company, or subcontracting with an entity contracting with the Company, to process claims for covered benefits under the program.

Related to Procedure for Review of Denied Claims

  • Procedure for Rebate The Association represents to the Board that an internal rebate procedure has been established in accordance with Section 4117.09(C) of the Revised Code and that a procedure for challenging the amount of the representation fee has been established and will be given to each member of the bargaining unit who does not join the Association and that such procedure and notice shall be in compliance with all applicable state and federal laws and the Constitutions of the United States and the State of Ohio.

  • Procedure for Payment Whenever a payment for fractional Rights, Preferred Shares or Common Shares is to be made by the Rights Agent pursuant to this Agreement, the Company will (i) promptly prepare and deliver to the Rights Agent a certificate setting forth in reasonable detail the facts related to such payment and the prices or formulas utilized in calculating such payments; and (ii) provide sufficient monies to the Rights Agent to make such payments. The Rights Agent will be fully protected in relying upon such certificate and will have no duty with respect thereto, and will not be deemed to have knowledge of any payment for fractional Rights, Preferred Shares or Common Shares pursuant to this Agreement unless and until the Rights Agent has received such certificate and sufficient monies.

  • Appeals Procedure If Employee appeals to the Administrator, Employee or his authorized representative may submit in writing whatever issues and comments he believes to be pertinent. The Administrator shall reexamine all facts related to the appeal and make a final determination of whether the denial of benefits is justified under the circumstances. The Administrator shall advise Employee in writing of:

  • Procedure for Benefits Modifications 1. Proposals for major retirement benefit modifications will be negotiated in joint meetings with the certified employee organizations whose memberships will be directly affected. Agreements reached between Management and organizations whereby a majority of the members in LACERS are affected shall be recommended to the City Council by the CAO as affecting the membership of all employees in LACERS. Such modifications need not be included in the MOU in order to be considered appropriately negotiated.

  • 000 GRIEVANCE PROCEDURE 7.100 It is agreed that it is the spirit and intent of this Agreement to adjust grievances promptly. All grievances, including discharge for just cause, but not those pertaining to jurisdictional disputes that may arise on any work covered by this Agreement, must be initiated within fifteen (15) working days of the incident by either the employee in Step I or the Local Union in Step II and shall be handled in the following manner:

  • PROCEDURE FOR TESTING A. Notification Form - Before requesting an employee to undergo drug or alcohol testing, the Employer shall provide the individual with a form on which to (1) acknowledge that the individual has seen a copy of the Employer's Drug and Alcohol Testing LOA, and (2) indicate consent to undergo the drug and alcohol testing.

  • Review Procedure If the Plan Administrator denies part or all of the claim, the claimant shall have the opportunity for a full and fair review by the Plan Administrator of the denial, as follows:

  • Procedure for resolving issues As soon as possible after an issue has been reported, the Employer’s Site Safety Supervisor or another management representative and the Health and Safety Representative must meet and try to resolve the issue. The resolution of the relevant issue must take into account any of the following factors that may be relevant-

  • Complaints Procedure 18.1 If the Client has any cause for complaint in relation to the services provided by the Company, he should file a complaint as per the Company’s Complaint Handling policy which is available on the Company’s website.

  • GRIEVANCE PROCEDURE 7 Section 4.1. Definition 7 Section 4.2. Procedures 7 Section 4.3. Limitations on Authority of Arbitrator 8 Section 4.4. Expenses of Arbitration 9 Section 4.5. Union Grievances 9 Section 4.6. Time Limits 9 Section 4.7. Miscellaneous 10 Section 4.8. Discipline 10 Section 4.9. Oral or Written Reprimands 11 Section 4.10. Applicability of Grievance and Arbitration Procedure to Discipline 11 ARTICLE V LABOR-MANAGEMENT COMMITTEE 12 ARTICLE VI SENIORITY, LAYOFF AND RECALL 13 Section 6.1. Definition 13 Section 6.2. Probationary Period 13 Section 6.3. Layoff and Recall 13 Section 6.4. Seniority List 15 Section 6.5. Posting of Certain Training Opportunities 15 Section 6.6. Termination of Seniority 15 Section 6.7. Reemployment After Expiration of Right to Recall 16 ARTICLE VII HOURS OF WORK AND OVERTIME 17 Section 7.1. Purpose 17 Section 7.2. Normal Work Cycle 17 Section 7.3. A Day Trades 18 Section 7.4. Overtime 19 Section 7.5. Changing or Trading Tours of Duty 19 Section 7.6. Hireback Procedure 19 Section 7.7. Compensatory Time 20 Section 7.8. Call-Back Pay 21 Section 7.9. No Pyramiding 21 ARTICLE VIII SALARIES AND OTHER COMPENSATION 22 Section 8.1. Salaries 22 Section 8.2. Longevity Pay 24 Section 8.3. Out of Classification Pay 25 Section 8.4. Paramedic Stipend 25 Section 8.5. Paramedic Preceptor 25 ARTICLE IX VACATIONS 26 Section 9.1. Amount of Vacation 26 Section 9.2. Vacation Eligibility 26 Section 9.3. Vacation Scheduling 26 Section 9.4. Limitation on Accumulation of Vacation 27 Section 9.5. Pay Upon Separation 28 Section 9.6. Vacation Day Trades 28 ARTICLE X HOLIDAYS 29 Section 10.1. Holidays for Employees Assigned to 8-Hour Shifts. 29 Section 10.2. Holidays for Employees Assigned to 24-Hour Shifts 30 Section 10.3. Pay for Hirebacks on Holidays 30 ARTICLE XI INSURANCE 31 Section 11.1. Caferteria Benefits Plan 31 Section 11.2. Retirees Insurance 31 Section 11.3. Flexible Benefits Plan 31 Section 11.4. Right to Change Carriers 31 Section 11.5. Terms of Policies to Govern 32 Section 11.6. Right to Maintain Coverage While on Unpaid Leave or on Layoff 32 Section 11.7. Post Retirement Health Savings Plan 32 ARTICLE XII LEAVES OF ABSENCE 33 Section 12.1. Jury Duty 33 Section 12.2. Sick Leave 33 Section 12.3. Special Leaves Without Pay 34 Section 12.4. Bereavement Leave 34 Section 12.5. Emergency Leave for Illness/Injury in Immediate Family 34 Section 12.6. Witness Leave 35 Section 12.7. Family and Medical Leave Act of 1993 36 Section 12.8. Pregnancy Leave/Maternity Leave 36 ARTICLE XIII SAFETY COMMITTEE 37 ARTICLE XIV MAINTENANCE OF SPECIFIC WORKING CONDITIONS 38 ARTICLE XV MISCELLANEOUS FRINGE BENEFITS 39 Section 15.1. Deferred Compensation Plan 39 Section 15.2. Credit Union 39 Section 15.3. Tuition Reimbursement 39 Section 15.4. Quartermaster System and Maintenance Allowance 39 Section 15.5. Sick Leave Incentive Plan 39 Section 15.6. Pay for Unused Sick Leave at Retirement 40 Section 15.7. Severance Pay 40 Section 15.8. Inoculations 40 Section 15.9. Eye Glass Replacement 41 ARTICLE XVI MISCELLANEOUS 42 Section 16.1. Outside Employment 42 Section 16.2. Pay Advance 42 Section 16.3. Gender of Words 42 Section 16.4. Physical Examinations 42 Section 16.5. Job Descriptions 42 Section 16.6. Posting of Formal Training Opportunities 43 Section 16.7. Released Time 43 Section 16.8. Resolution of Impasse 43 Section 16.9. Solicitation 43 Section 16.10. Physical Fitness Program 44 Section 16.11. Shift/Station Selection Process 44 Section 16.12. Subcontracting 48 ARTICLE XVII RIGHTS OF VILLAGE 49 ARTICLE XVIII NON-INTERRUPTION OF WORK 50 Section 18.1. No Strikes 50 Section 18.2. No Lockouts 50 ARTICLE XIX PROMOTIONS 51 Section 19.1. General 51 Section 19.2. Eligibility Requirements 51 Section 19.3. Components of the Promotional Process and the Weighting of Components 52 Section 19.4. Promotion Process Components 53 Section 19.5. Promotions Coordinator 58 Section 19.6. Monitors 58 Section 19.7. Scoring of Components and Posting of Preliminary Promotion List 59 Section 19.8. Veteran's Preference Points and Posting of Final Promotion List 59 Section 19.9. Order of Selection 60 Section 19.10. Duration of Final Promotion List 61 Section 19.11. Right to Review 61 ARTICLE XX SAVINGS CLAUSE 63 ARTICLE XXI ENTIRE AGREEMENT 64 ARTICLE XXII DRUG AND ALCOHOL TESTING 65 ARTICLE XXIII DURATION AND TERM 67 Section 23.1. Term of Agreement 67 Section 23.2. Continuing Effect 67 APPENDIX A VARIANCES FROM STATUTORY IMPASSE PROCEDURE 00 XXXXXXXX X ESSENTIAL JOB FUNCTIONS TESTING 69 APPENDIX C FIRE CHIEF’S EVALUATION INSTRUMENT 75 APPENDIX D VILLAGE’S CAFETERIA BENEFITS PLAN 00 XXXXXXXX X ADDITIONAL QUARTERMASTER ITEMS 77 APPENDIX F CURRENT LIST OF 40 HOUR OR LONGER OFFICE OF STATE FIRE MARSHAL COURSES 78 OCTOBER 23, 1990 MINIMUM STAFFING SIDE LETTER… 80 AGREEMENT This Agreement is made and entered into by and between the Village of Schaumburg (hereinafter referred to as the “Village”) and the Schaumburg Professional Firefighters Association, IAFF Local 4092 (hereinafter referred to as the “Union”).

Draft better contracts in just 5 minutes Get the weekly Law Insider newsletter packed with expert videos, webinars, ebooks, and more!