Claim Decision definition

Claim Decision means the document used by the Defendant to advise Claimants of whether and to what extent their claims are approved or denied.
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Claim Decision means a decision of the Claims Adjudicator to approve, deny or terminate a claim.
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Examples of Claim Decision in a sentence

  • How to Appeal a Claim Decision How to Request an AppealIf you disagree with either a claim determination or a rescission of coverage determination, you can contact us in writing to formally request an appeal.Your request for an appeal should include: The patient's name and Policy number. The date(s) of Vision Service(s). The provider's name. The reason you believe the claim should be paid. Any documentation or other written information to support your request for claim payment.

  • What to Do First 60How to Appeal a Claim Decision 60Appeal Process 61Appeals Determinations.

  • What to Do First 65How to Appeal a Claim Decision 65Appeal Process 65Appeals Determinations.

  • On May 22, 2020, the Commission on State Mandates (Commission) adopted the Test Claim Decision finding that Government Code section 12525.5, as added and amended by Statutes 2015, chapter 466 and Statutes 2017, chapter 328, and California Code of Regulations, title 11,sections 999.224- 999.229 (Register 2017, No. 46), constitute a reimbursable state-mandated program within the meaning of article XIII B, section 6 of the California Constitution, beginning November 7, 2017.

  • The second test is met if the taxpayer performs more than 750 hours of services during the year in real property trades or businesses in which the taxpayer materially participates.

  • On July 24, 2020, the Commission on State Mandates (Commission) adopted the Test Claim Decision finding that Elections Code section 3010, as amended by Statutes 2018, chapter 120, imposes a reimbursable state-mandated program on cities and counties within the meaning of article XIII B, section 6 of the California Constitution and Government Code section 17514.

  • On September 27, 2019, the Commission adopted a new Test Claim decision, finding that Statutes 2015, chapter 572, and Statutes 2017, chapter 641, constitute a subsequent change in law that eliminates the state’s liability for reimbursement under the previously adopted Test Claim Decision, beginningJuly 1, 2016.

  • Unless mutually agreed upon by both parties in writing, the Claimant will file written submissions setting out their position on the issues and explain why they believe that there exists an Error in the Claim Decision along with reference to any documents from the Claim File that a party intends to rely on in the arbitration.

  • On September 27, 2019, Commission staff issued the Draft Proposed Decision for the second hearing and the Draft Expedited Proposed Decision and Amendment to Parameters and Guidelines.4 On October 18, 2019, the Controller filed comments on the Draft Expedited Proposed Decision and Amendment to Parameters and Guidelines, recommending no changes.5 On November 22, 2019, the Commission adopted the Proposed Decision for the second hearing as its new Test Claim Decision.

  • DETERMINATION OF BENEFITS 12 9.1 Claim 12 9.2 Claim Decision 12 9.3 Request for Review 12 9.4 Review of Decision 12 ARTICLE X.

Related to Claim Decision

  • Final Decision means a final action of the commission determining the legal rights, duties, or privileges of any person. “Final decision” does not include preliminary, procedural, or intermediate actions by the commission, actions regulating the internal administration of the commission, or actions of the commission to enter into or refrain from entering into contracts or agreements with vendors to provide goods or services to the commission.

  • key decision * means an executive decision which is likely to:

  • Adverse decision means any decision by a review agent not to certify an admission,

  • return decision means an administrative or judicial decision or act, stating or declaring the stay of a third-country national to be illegal and imposing or stating an obligation to return;

  • Land use decision means an administrative decision of a land use authority or appeal authority regarding:

  • Informed decision means a decision by a qualified patient to request and obtain a prescription for medication that the qualified patient may self-administer to end the qualified patient's life in a humane and dignified manner that is based on an appreciation of the relevant facts and that is made after being fully informed by the attending physician of:

  • Proposed decision means the presiding officer’s recommended findings of fact, conclusions of law, decision, and order in a contested case in which the administrator did not preside.

  • Adequacy Decision means a decision issued by the European Commission that a country or region or a category of recipients in such country or region is deemed to provide an “adequate” level of data protection.

  • CPUC Decisions means CPUC Decisions 00-00-000, 00-00-000, 00-00-000, 00-00-000, 00-00-000, 00-00-000, 00-00-000, 00-00-000, 00-00-000, 00-00-000, 00-00-000, 00-00-000, 00-00-000, 00-00-000, 00-00-000, 00-00-000, 00-00-000, 00-00-000 and any other existing or subsequent decisions, resolutions or rulings related to resource adequacy, as may be amended from time to time by the CPUC.

  • the decisions means the decisions of the CMA on the questions which it is required to answer by virtue of section 35 of the Act;

  • Indemnification Claim Notice has the meaning set forth in Section 11.3.

  • Appellate Decision-maker means a person who considers and decides appeals of determinations regarding responsibility and dismissals of formal complaints. The Appellate Decision-maker cannot be the same person as the Title IX Coordinator, Investigator, or Decision-maker. The Appellate Decision-maker may be a school district employee, or a third party designated by the school district.

  • Claim Deadline means the last date by which a Claim submitted to the Settlement Administrator by a Settlement Class Member must be postmarked or submitted electronically, which will be ninety (90) Days after the Notice Deadline. All Claims postmarked or submitted electronically at the Settlement Website on or before the Claim Deadline shall be timely, and all Claims postmarked or submitted electronically at the Settlement Website after the Claim Deadline shall be untimely and barred from entitlement to any Settlement Relief.

  • Final administrative decision means a decision by an agency

  • Labor law decision means an administrative merits determination, arbitral award or decision, or civil judgment, which resulted from a violation of one or more of the laws listed in the definition of “labor laws”.

  • Indemnification Claim has the meaning set forth in Section 8.4(a).

  • Record of Decision means a Record of Decision of an application for municipal planning approval as contemplated in section 55;

  • Unresolved Claim means a Claim, which at the relevant time, in whole or in part: (a) has not been Finally Determined to be a Proven Claim in accordance with the Amended Claims Procedure Order and this Plan; (b) is validly disputed in accordance with the Amended Claims Procedure Order; and/or (c) remains subject to review and for which a Notice of Allowance or Notice of Revision or Disallowance (each as defined in the Amended Claims Procedure Order) has not been issued to the Creditor in accordance with the Amended Claims Procedure Order as at the date of this Plan, in each of the foregoing clauses, including both as to proof and/or quantum;

  • Major Decision means:

  • Claim Notice has the meaning set forth in Section 8.4(a).

  • Rejection Claim means a Claim arising from the rejection of an Executory Contract or Unexpired Lease pursuant to section 365 of the Bankruptcy Code.

  • Responsible Respondent means a Respondent that has the capability in all material respects to perform the scope of work and specifications of the Contract. In determining whether a Respondent is a Responsible Respondent, the Agency may consider various factors including, but not limited to, the Respondent’s competence and qualifications to provide the goods or services requested, the Respondent’s integrity and reliability, the past performance of the Respondent and the best interest of the Agency and the State.

  • Indemnified Claim has the meaning set forth in Section 8.2.

  • Response Action means the investigation, cleanup, removal, remediation, containment, control, abatement, monitoring of or any other response action to the presence of Regulated Substances or Contamination in, on, at, under or emanating from the Stadium Site, including the correction or abatement of any violation required pursuant to Environmental Laws or by a Governmental Authority.

  • Claim Objection Deadline means the first Business Day that is 180 days after the Effective Date, as may be extended by order of the Bankruptcy Court.

  • Claim Form or “Proof of Claim Form” means the form, substantially in the form attached hereto as Exhibit 2 to Exhibit A, that a Claimant or Settlement Class Member must complete and submit should that Claimant or Settlement Class Member seek to share in a distribution of the Net Settlement Fund.