Claims Audit definition

Claims Audit means the claims review performed by Guardrisk Life Limited on all its binder holders to assess the claims process (flow) documentation, the application of sound and consistent decisions, the application of fairness, equitable and objective claims handling principles, the assessment of claims staff capabilities and the safe keeping and reporting of all claims documentation. For purposes of this definition, a claims audit will be performed as often as is required should a binder holder not be able to demonstrate fair, objective, equitable or consistent claims handling management processes.
View Source
Claims Audit shall have the meaning set forth in Section 4b. of this Agreement.
View Source
Claims Audit means the claims review performed by Guardrisk on all its binder holders or only new binder holders to assess the claims process (flow) of assessments, the application of sound and consistent decisions, the application of fairness, equitable and objective claims handling principles, the assessment of claims staff capabilities and the safe keeping and reporting of all claim’s documentation. For purposes of this definition, a claims audit will be performed on a risk based approach every 2 (two) to 3 (three) years, or when deemed applicable and will be applied in addition to claims sampling on a binder holder to ensure fair, objective, equitable or consistent claims handling management processes.
View Source

Examples of Claims Audit in a sentence

  • The duration of the Processing covers the period of this Grant Agreement and any period thereafter where the GLA require the data in respect of activity that the GLA is required to carry out in respect of Monitoring, Claims, Audit or Evaluation, up to the Retention Date as defined in clause 13.1.4 of this Grant Agreement.

  • The fee to perform the medical claims audit portion of the 100% Claims Audit is $48,000.00 (“Medical Claims Audit Fee”).

  • The fee to perform the dental claims audit portion of the 100% Claims Audit is $17,000.00 (“Dental Claims Audit Fee”).

  • The 100% Claims Audit consists of the following six tasks to be performed by TFG Partners.

  • The Claims Audit covers a period of time beyond the scope of the original Examination, and, therefore, the Lead States reserve the right to additional examination(s) of HCC Life as a result of the Claims Audit together with the right to impose financial, regulatory, and performance sanctions with respect thereto.

  • HCC Life shall be responsible for the full, complete, and prompt payment of all fees and expenses of the Examiner-in-Charge in conducting and reporting on the Claims Audit in compliance with the laws of the State of Indiana.

  • Within one hundred twenty (120) days of the Final Effective Date, the Examiner-in- Charge shall commence a preliminary audit (in accordance with the NAIC Market Regulation Handbook) of HCC Life's claims handling practices for the STM Products for the period of June 1, 2017 through the date of the commencement of such examination (the "Claims Audit").

  • Upon completion of the Claims Audit, the Examiner- in-Charge shall present his preliminary findings to the Lead States.

  • Upon the request of a Participating State, the Examiner-in-Charge shall provide any final reports regarding the Claims Audit previously provided to Lead States to such Participating State.

  • Claims Audit Credit $20,000 00 One credit of actual costs, up to $20,000, during the initial three year contract.


More Definitions of Claims Audit

Claims Audit means the annual review performed by Guardrisk on its binder holders to assess the claims process (flow) documentation, the application of sound and consistent decisions, the application of fairness, equitable and objective claims handling principles in line with TCF (“Treating Customers Fairly”), The PPR’s (“Policyholder Protection Rules”), sound claims knowledge and technical skills and abilities and the assessment of claims staff capabilities and the safe keeping and reporting of all claims documentation;
View Source
Claims Audit means the claims review performed by Guardrisk on all its binder holders or only new binder holders to assess the claims process (flow) of assessments, the application of sound
View Source

Related to Claims Audit

  • Company’s Auditors means the chartered accountant or firm of chartered accountants duly appointed as auditor or auditors of the Company from time to time;

  • Notice and Claims Agent means Prime Clerk LLC.

  • Claims Agent means Kurtzman Carson Consultants LLC.

  • Claims Administration means the processing of claims made under the Shared Policies, including the reporting of claims to the insurance carriers, management and defense of claims and providing for appropriate releases upon settlement of claims.

  • Claims Bar Date means the applicable bar date by which Proofs of Claim must be Filed, as established by: (a) the Bar Date Order; (b) a Final Order of the Bankruptcy Court; or (c) the Plan.