Review by Claims Administrator Sample Clauses

Review by Claims Administrator. The Claims Administrator will review all submitted Claim Forms within a reasonable time to determine each Settlement Class Member’s eligibility for relief, and the amount of such relief, if any. Copies of submitted Claim Forms will be provided to CVS’s Counsel and to Class Counsel on request. Settlement Class Members submitting valid Claim Forms will be entitled to relief as set forth in this Agreement. Settlement Class Members who submit Claim Forms that are not eligible for relief based on the criteria set forth in this Agreement will not be entitled to relief.
AutoNDA by SimpleDocs
Review by Claims Administrator. Claim Packages shall be submitted to the Claims Administrator. After receiving a Claim Package, the Claims Administrator shall conduct the following analysis of the Claim Package:
Review by Claims Administrator. The Claims Administrator shall review all submitted Claim Forms within a reasonable time to determine each Settlement Class Member’s eligibility for relief, and the amount of such relief, if any. Copies of submitted Claim Forms shall be provided to Defense Counsel and to Class Counsel upon request. Settlement Class Members who submit valid Claim Forms shall be entitled to relief as set forth in Section IV of this Stipulation of Settlement. Settlement Class Members who submit Claims Forms that do not meet the Eligibility Requirements or the Requirements for valid Claim Forms, as described in this Section VII of this Stipulation of Settlement, shall not be entitled to the relief set forth in Section IV of this Stipulation of Settlement. The Claims Administrator shall use standard and customary procedures to prevent the payment of fraudulent claims and to pay only legitimate claims.

Related to Review by Claims Administrator

  • Claims Administrator A. The Human Resources Director through his/her designated Claims Administrators shall administer the provision of this policy. The City Physician shall provide the City's Claims Administrators with all available medical information concerning the Employee's injury and/or medical opinions as requested. Medical information and opinions shall be based upon the Employee's medical records and/or physical examination. Questions of Employee eligibility shall be determined by the provisions established under State Statute 49-110, 49-111 and Oklahoma Worker's Compensation Title 85. Prior to any denial of injury leave benefits where lost time actually occurred, the administrator shall notify Union and allow a Union representative the opportunity to review the application pending denial and provide any additional information relating to same as may be necessary. Should the City change designated Claims Administrators Local 176 will be notified in writing.

  • Claims Administration An employee will be required to comply with any and all rules and regulations and/or limitations established by the carrier or applicable third party administrator and contained in the policy, and employees and their dependents shall look solely to such carrier or third party administration for the adjudication of the payment of any and all benefits claims.

  • Claims Review Report The IRO shall prepare a Claims Review Report as described in this Appendix for each Claims Review performed. The following information shall be included in the Claims Review Report for each Discovery Sample and Full Sample (if applicable).

  • Claims Review Population A description of the Population subject to the Claims Review.

  • Claims Submission We will submit your claims and assist you in any way we reasonably can to help get your claims paid. Your insurance company may need you to supply certain information directly. It is your responsibility to comply with their request. Please be aware that the balance of your claim is your responsibility whether or not your insurance company pays your claim. Your insurance benefit is a contract between you and your insurance company; we are not party to that contract.

  • Claims Review Findings a. Narrative Results.‌‌

  • Claims Review The IRO shall perform the Claims Review annually to cover each of the five Reporting Periods. The IRO shall perform all components of each Claims Review.

  • 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:

  • Claims Review Methodology a. C laims Review Population. A description of the Population subject to the Quarterly Claims Review.‌

  • Claims Review Objective A clear statement of the objective intended to be achieved by the Claims Review.

Time is Money Join Law Insider Premium to draft better contracts faster.