Common use of Review of Claim Denial Clause in Contracts

Review of Claim Denial. If a claim is denied, in whole or in part, the claimant shall have the right to request that the Administrator review the denial, provided that the claimant files a written request for review with the Administrator within sixty (60) days after the date on which the claimant received written notification of the denial. A claimant (or his duly authorized representative) may review pertinent documents and submit issues and comments in writing to the Administrator. Within sixty (60) days after a request is received, the review shall be made and the claimant shall be advised in writing of the decision on review , unless special circumstances require an extension of time for processing the review, in which case the claimant shall be given a written notification within such initial sixty (60) day period specifying the reasons for the extension and when such review shall be completed (provided that such review shall be completed within one hundred and twenty (120) days after the date on which the request for review was filed.) The decision on review shall be forwarded to the claimant in writing and shall include specific reasons for the decision and references to plan provisions upon which the decision is based. A decision on review shall be final and binding on all persons.

Review of Claim Denial. If a claim is denied, in whole or in part, the claimant shall you will have the right to request that the Administrator Compensation Committee review the denial, provided that the claimant files you file a written request for review with the Administrator Compensation Committee within sixty (60) days after the date on which the claimant you received written notification of the denial. A claimant You (or his your duly authorized representative) may review pertinent documents and submit issues and comments in writing to the AdministratorCompensation Committee. Within sixty (60) days after a request for review is received, the review shall be made and the claimant shall you will be advised in writing of the decision on review review, unless special circumstances require an extension of time for processing the review, in which case the claimant shall you will be given a written notification within such initial sixty (60) day period specifying the reasons for the extension and when such review shall be completed (provided that such review shall be completed within one hundred and twenty (120) days after the date on which the request for review was filed.) ). The decision on review shall be forwarded to the claimant you in writing and shall include specific reasons for the decision and references to plan the provisions of this Agreement upon which the decision is based. A decision on If you fail to file a request for review in accordance with the procedures herein outlined, you will have no rights to review and will have no right to bring action in any court and the denial of the claim shall be become final and binding on all personspersons for all purposes.

Review of Claim Denial. If a claim is denied, in whole or in part, the claimant shall have the right to request that the Administrator review the denial, provided that the claimant files a written request for review with the Administrator within sixty (60) days after the date on which the claimant received written notification of the denial. A claimant (or his duly authorized representative) may review pertinent documents and submit issues and comments in writing to the Administrator. Within sixty (60) days after a request is received, the review shall be made and the claimant shall be advised in writing of the decision on review review, unless special circumstances require an extension of time for processing the review, in which case the claimant shall be given a written notification within such initial sixty (60) day period specifying the reasons for the extension and when such review shall be completed (provided that such review shall be completed within one hundred and twenty (120) days after the date on which the request for review was filed.) The decision on review shall be forwarded to the claimant in writing and shall include specific reasons for the decision and references to plan provisions upon which the decision is based. A decision on review shall be final and binding on all persons.