Common use of Review of Decision Clause in Contracts

Review of Decision. The Review Plan Administrator shall advise the Claimant in writing of the Review Plan Administrator’s determination of the appear within 60 days of the Review Plan Administrator’s receipt of Claimant’s written request for review, unless special circumstances (such as a hearing) would make the rendering of a determination within the 60 day period infeasible, but in no event shall the Review Plan Administrator render a determination regarding the denial of a claim for benefits later than 120 days after its receipt of a request for review. If an extension of time for review is required because of special circumstances, written notice of the extension shall be furnished to the Claimant prior to the date the extension period commences. If the Claimant’s appeal of the denial of the Claimant’s benefits claim is denied in whole or in part, the Review Plan Administrator shall adopt a written opinion, using language calculated to be understood by the Claimant, setting forth: (i) The specific reasons for such denial of the appeal; (ii) Specific reference to pertinent provisions of this Plan on which such denial of the appeal is based; (iii) A statement that the Claimant is entitled to receive, upon request and free of charge, reasonable access to, and copies of, all documents, records and other information relevant to the Claimant’s benefits claim (and a document, record or other information shall be considered “relevant” to the benefits claims as provided in Department of Labor Regulation Section 2560.503-1(m)(8); and (iv) A statement describing the Claimant’s right to bring an action under ERISA Section 502(a).