The Claims Administrator and Claims Facility Sample Clauses

The Claims Administrator and Claims Facility. (i) Prior to the Effective Date Of This Agreement, and subject to the approval of the British Columbia Court, the Plaintiff will propose a Claims Administrator and a Claims Facility to be agreed upon by Dow Corning and appointed by the British Columbia Court for the purposes of, under the authority of the British Columbia Court, processing and classifying the Opt-Out Forms, Registration/Opt-In Forms, Claim Forms, Ongoing Claim Forms Product Identification Documentation, Supporting Medical Documentation and Releases of Dow Corning and the Released Parties, evaluating claims and assigning the status of Approved Claimant to qualifying Eligible Claimants, all as provided in this Agreement, including the provisions and procedures set forth in the Claims Administration Procedures.
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The Claims Administrator and Claims Facility. After the approval hearing held by the Ontario Court, as described in Section 3, above, and before the entry of the Confirmed Plan of Reorganization, Settlement Class Counsel will propose a Claims Administrator and a Claims Facility to be agreed upon by the Parties and appointed by the Ontario Court for the purposes of, under the authority of the Ontario Court, processing and classifying the Registration Forms, Claim Forms, Product Identification Documentation, Supporting Documentation and Releases of Dow Corning and the Released Parties and assigning the status of Approved Claimant to Eligible Claimants and thereafter paying Approved Claimants, all as provided in this Agreement, including the provisions and procedures set forth in the Claims Administration Procedures, attached as Exhibit D to this Agreement.
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Related to The Claims Administrator and Claims Facility

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

  • 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.

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

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

  • Disputed Claims 4.1 Notwithstanding paragraph 4.5 of this Schedule, payment by the Authority of all or any part of any invoice rendered or other claim for payment by the Contractor shall not signify approval of such invoice/claim. The Authority reserves the right to verify invoices/claims after the date of payment and subsequently to recover any sums which have been overpaid.

  • Plan Arrangements Eligibility – Claim Types All claim types are eligible to be processed through Inter-Plan Arrangements, as described above, except for all dental benefits, and those prescription drug benefits or vision benefits that may be administered by a third party contracted by us to provide the specific service or services. BlueCard® Program Under the BlueCard® Program, when you receive covered healthcare services within the geographic area served by a Host Blue, BCBSRI will remain responsible for doing what we agreed to in the contract. However, the Host Blue is responsible for contracting with and generally handling all interactions with its participating providers. When you receive covered healthcare services outside our service area and the claim is processed through the BlueCard Program, the amount you pay for covered healthcare services is calculated based on the lower of: • the billed covered charges for your covered services; or • the negotiated price that the Host Blue makes available to BCBSRI. Often, this “negotiated price” will be a simple discount that reflects an actual price that the Host Blue pays to your healthcare provider. Sometimes, it is an estimated price that takes into account special arrangements with your healthcare provider or provider group that may include types of settlements, incentive payments and/or other credits or charges. Occasionally, it may be an average price, based on a discount that results in expected average savings for similar types of healthcare providers after taking into account the same types of transactions as with an estimated price. Estimated pricing and average pricing also take into account adjustments to correct for over- or underestimation of past pricing of claims, as noted above. However, such adjustments will not affect the price we have used for your claim because they will not be applied after a claim has already been paid. Negotiated (non–BlueCard Program) Arrangements With respect to one or more Host Blues, in certain instances, instead of using the BlueCard Program, we may process your claims for covered healthcare services through Negotiated Arrangements for National Accounts. The amount you pay for covered healthcare services under this arrangement will be calculated based on the negotiated price (refer to the description of negotiated price in the BlueCard® Program section above) made available to us by the Host Blue.

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