Common use of Processing a Claim Clause in Contracts

Processing a Claim. 1. Where the agency of one Contracting State receives a claim of a person, who has completed periods of coverage under the legislation of the other or both Contracting States, this agency shall send the claim through the liaison agency to the agency of the other Contracting State, indicating the date on which the claim has been received. Along with the claim, it will also transmit to the agency of the other Contracting State: - any available documentation that may be necessary for the agency of the other Contracting State to establish the claimant’s eligibility for the benefit, - form which will indicate, in particular, the periods of coverage completed under the legislation of the first Contracting State, - and, eventually, a copy of its own decision on benefit if it has been taken on. 2. The agency of the other Contracting State subsequently determines the claimant’s eligibility and notifies through the liaison agency its decision to the agency of the first Contracting State. Along with its decision, it will also transmit, if necessary or upon the request, to the agency of the first Contracting State: - any available documentation that may be necessary for the agency of the first Contracting State to establish the claimant’s eligibility for the benefit, - form which will indicate, in particular, the periods of coverage completed under the legislation which it applies. 3. The agency of the Contracting State with which a claim for benefits has been filed shall verify the information pertaining to the claimant and his family members. The type of information to be verified shall be agreed upon by the liaison agencies of the two Contracting States.

Processing a Claim. 1. Where the agency institution of one Contracting State receives a claim of a person, who has completed periods of coverage insurance under the legislation of the other or both Contracting States, this agency institution shall send the claim through the liaison agency bodies to the agency institution of the other Contracting State, indicating the date on which the claim has been received. Along with the claim, it will also transmit to the agency institution of the other Contracting State: - any available documentation that may be necessary for the agency institution of the other Contracting State to establish the claimant’s eligibility for the benefit, - form which will indicate, in particular, the periods of coverage insurance completed under the legislation of the first Contracting State, - and, eventually, and a copy of its own decision on benefit if it has been taken on. 2. The agency institution of the other Contracting State subsequently determines the claimant’s eligibility and notifies through the liaison agency bodies its decision to the agency institution of the first Contracting State. Along with its decision, it will also transmit, if necessary or upon the request, to the agency institution of the first Contracting State: - any available documentation that may be necessary for the agency institution of the first Contracting State to establish the claimant’s eligibility for the benefit, - form which will indicate, in particular, the periods of coverage insurance completed under the legislation which it applies. 3. The agency institution of the Contracting State with which a claim for benefits has been filed shall verify the information pertaining to the claimant and his family members. The type of information to be verified shall be agreed upon by the liaison agencies bodies of the two Contracting States.