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.
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Claims Audit shall have the meaning set forth in Section 4b. of this Agreement.
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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;
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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 initial term of the Contract will begin upon the date last signed below and continue until the date that the Annual Post Payment Claims Audit Report is submitted to the Department for the third audit period, unless extended, terminated, or renewed as provided herein.

  • AR-28 Annual Post Payment Claims Audit Report: detailing the audit methodology, audit findings and observations, total overpayments identified and total overpayments collected during each reporting period.

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

  • Annual Post Payment Claims Audit Reports Reports and Deliverables that are provided to the Department shall be accurate.

  • The Annual Post Payment Claims Audit Report shall include an executive summary, audit scope, methodology, results and findings, and recommended corrective actions.

  • Annual Post Payment Claims Audit Reports All reports and Deliverables shall be delivered to theDepartment within the time period specified.

Related to Claims Audit

  • Company’s Auditors means an independent firm of accountants duly appointed as auditors of the Company;

  • 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, without limitation, the reporting of claims to the insurance carriers and the management of the defense 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.

  • Claims Administrator means the firm proposed by Class Counsel and appointed by the Courts to administer the Settlement Amount in accordance with the provisions of this Settlement Agreement and the Distribution Protocol, and any employees of such firm.

  • Audit means the examination of a person or the inspection of the books, records, memoranda, or accounts of a person, ordered to appear before the Tax Administrator, for the purpose of determining liability for a municipal income tax.

  • Statement of Grievance shall name the grievant(s) involved, the facts giving rise to the grievance, provision(s) of the Agreement alleged to be violated and the remedy (specific relief) requested.

  • Tax Audit means any audit, assessment, or other examination relating to Taxes by any Tax Authority or any judicial or administrative proceedings relating to Taxes.

  • Grievance Committee means the Grievance Committee of the Bar.

  • Claims Bar Date Order means that certain order entered by the Bankruptcy Court establishing the Claims Bar Date.

  • Review Panel means the panel, if any, appointed pursuant toRule 710 to review a completed Investigation Report and to determine whether a reasonable basis exists for finding a violation of the Rules and authorizing the issuance of a notice of charge pursuant to Rule 706.

  • Claims Objection Bar Date means the deadline for objecting to a Claim, which shall be on the date that is the later of (a) 180 days after the Effective Date and (b) such other period of limitation as may be specifically fixed by the Debtors or the Reorganized Debtors, as applicable, or by an order of the Bankruptcy Court for objecting to Claims.

  • Disputed Claims Reserve means a reserve of Cash that may be funded on or after the Effective Date pursuant to Article VII.E hereof.

  • Appeals Panel means a panel appointed by the Chief Compliance Officer pursuant to Rule 620.

  • Benchmarking Report means the report produced by the Supplier following the Benchmark Review and as further described in this Framework Schedule 7;

  • Audits means the audits and reviews carried out by the Bank or the Bank’s auditors, experts and insurers, as the case may be in accordance with the terms and conditions set out in Section 18.

  • Root Cause Analysis Report means a report addressing a problem or non-conformance, in order to get to the ‘root cause’ of the problem, which thereby assists in correcting or eliminating the cause, and prevent the problem from recurring.

  • Complaints Procedure means the School's procedure for handling complaints from parents, as amended from time to time for legal or other substantive reasons, or in order to assist the proper administration of the School. It does not form part of the contract between you and the School. A copy of the most up-to-date procedure is on the School's website and is otherwise available from the School at any time upon request;

  • Appeal Committee means the appeal committee established by the Council in terms of section 12(3)(a);

  • Administrative Claims Bar Date means the deadline for Filing requests for payment of Administrative Claims, which: (a) with respect to Administrative Claims other than Professional Fee Claims, shall be 30 days after the Effective Date; and (b) with respect to Professional Fee Claims, shall be 45 days after the Effective Date.

  • Appeal Panel means a panel comprised of a chair and two individuals appointed by the Board to consider appeals under Chapter 7.

  • QAP shall have the meaning set forth in Clause 11.2;

  • Unresolved Claims shall have the meaning set forth in Section 9.6(b).