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Common use of What Should You Do When You Want to Appeal a Decision Clause in Contracts

What Should You Do When You Want to Appeal a Decision. If You want to ask Us to change a decision that We made, You may file an Appeal. For example, You may Appeal Our decision if We denied a Claim based on Plan limitations or exclusions. When You file an Appeal, send Us all of the information You have so that We can completely evaluate Your situation. We try to respond quickly, review any documentation in a timely manner, and resolve disputes effectively. The Appeals process has two levels, including a committee review at the second level.‌ If You prefer, You can have someone else act for You. We call that person an authorized representative. If You want to name Your Physician or someone else as an authorized representative, You must write to Us that You want someone to work with Us for an Appeal of denied Benefits. We will notify Your providers of the Appeal results only if they filed the Appeal for You.

Appears in 5 contracts

Samples: Cancer and Serious Disease Limited Benefit Contract, Limited Benefit Contract, Cancer and Serious Disease Limited Benefit Contract

What Should You Do When You Want to Appeal a Decision. If You want to ask Us to change a decision that We made, You may file an Appeal. For example, You may Appeal Our decision if We denied a Claim based on Plan limitations or exclusions. When You file an Appeal, send Us all of the information You have so that We can completely evaluate Your situation. We try to respond quickly, review any documentation in a timely manner, and resolve disputes effectively. The Appeals process has two levels, including a committee review at the second level.‌ level. If You prefer, You can have someone else act for You. We call that person an authorized representative. If You want to name Your Physician doctor or someone else as an authorized representative, You must write to Us that You want someone to work with Us for an Appeal of denied Benefits. 1. We will notify Your providers of the Appeal results only if they filed the Appeal for You.

Appears in 3 contracts

Samples: Limited Benefit Contract, Variable Income Plan, Variable Income Plan

What Should You Do When You Want to Appeal a Decision. If You want to ask Us to change a decision that We made, You may file an Appeal. For example, You may Appeal Our decision if We denied a Claim based on Plan limitations or exclusions. When You file an Appeal, send Us all of the information You have so that We can completely evaluate Your situation. We try to respond quickly, review any documentation in a timely manner, and resolve disputes effectively. The Appeals process has two levels, including a committee review at the second level.‌ level. If You prefer, You can have someone else act for You. We call that person an authorized representative. If You want to name Your Physician or someone else as an authorized representative, You must write to Us that You want someone to work with Us for an Appeal of denied Benefits. We will notify Your providers of the Appeal results only if they filed the Appeal for You.

Appears in 2 contracts

Samples: Limited Benefit Contract, Limited Benefit Contract

What Should You Do When You Want to Appeal a Decision. If You want to ask Us to change a decision that We made, You may file an Appeal. For example, You may Appeal Our decision if We denied a Claim based on Plan limitations or exclusions. When You file an Appeal, send Us all of the information You have so that We can completely evaluate Your situation. We try to respond quickly, review any documentation in a timely manner, and resolve disputes effectively. The Appeals process has two levels, including a committee review at the second level.‌ level.‌‌ If You prefer, You can have someone else act for You. We call that person an authorized representative. If You want to name Your Physician or someone else as an authorized representative, You must write to Us that You want someone to work with Us for an Appeal of denied Benefits. We will notify Your providers of the Appeal results only if they filed the Appeal for You.

Appears in 1 contract

Samples: Limited Benefit Contract