Claims Fiduciary definition

Claims Fiduciary means the entity to which the Plan Sponsor has allocated certain fiduciary responsibility.
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Claims Fiduciary means the person or entity that serves as the named claims fiduciary with respect to reviewing and making final decisions regarding claims under a Welfare Program. The “Claims Fiduciary” shall be the Plan Administrator unless otherwise set forth in Appendix D to this SPD.
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Claims Fiduciary means the person or entity that serves as the named claims fiduciary with respect to reviewing and making final decisions regarding Claims under the HRA. The Plan Administrator will be the “Claims Fiduciary” for the HRA.
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Examples of Claims Fiduciary in a sentence

  • Notwithstanding anything in the Plan to the contrary, the Claims Fiduciary shall have total and complete discretion to fulfill its fiduciary responsibilities as it sees fit on a uniform and consistent basis and as it believes a prudent person acting in a like capacity and familiar with such matters would do.

  • The Plan Administrator will act as Claims Fiduciary, except to the extent that the Plan Administrator has delegated the function to some other person or persons, committee or entity.

  • The Company shall appoint a Claims Fiduciary (as such term is defined in Exhibit A) to review adverse benefit determinations as described in Exhibit A.

  • To be considered timely filed under the Plan's claims procedures and notwithstanding anything in this Part III to the contrary, a claim for benefits filed after 2015 must be filed with the appropriate Claims Fiduciary under Sections 9.02 or 9.08 of this Part III before the first (1st) anniversary of the date on which claimant knew or reasonably should have known of the principal facts upon which the claim is based.

  • If you are unsure who the Claims Fiduciary is, you may contact Crew Central.

  • A Claim will be considered to involve urgent care if the Claims Fiduciary or a physician with knowledge of your condition determines that the application of the claims procedures for non-urgent Claims (1) could seriously jeopardize your life or your health, or your ability to regain maximum function or (2) in your physician’s opinion, would subject you to severe pain that cannot adequately be managed without the care or treatment that is the subject of the Claim.

  • When a Claims Processor determines that a benefit is not payable under the Plan, any appeals of Adverse Benefit Determinations would be reviewed by the Claims Fiduciary.

  • Appealing a DenialIf you receive an Adverse Benefit Determination on your initial Claim (including a decision to discontinue or reduce benefits relating to an ongoing course of treatment), you may appeal the denial by filing a written request (or an oral request in the case of an Urgent Care Claim) with the appropriate Claims Fiduciary.

  • Filing a ClaimIf you wish to file a Claim, you must complete a written Claim on the proper form and submit it to the Claims Fiduciary or Claims Processor, as applicable, responsible for reviewing the Claim if it is not already submitted on your behalf by your provider.

  • The Plan Administrator will act as Claims Fiduciary except to the extent that the Plan Administrator has delegated the function to some other person or persons, committee or entity.


More Definitions of Claims Fiduciary

Claims Fiduciary means the person or entity that serves as the named claims fiduciary with respect to reviewing and making final decisions regarding claims under a Welfare Program. The Plan Administrator will be the “Claims Fiduciary” except as otherwise designated in Appendix C.
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Claims Fiduciary means the Insurance Company.
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Related to Claims Fiduciary

  • Named Fiduciary means the Fiduciary or Fiduciaries named herein or in the Adoption Agreement who jointly or severally have the authority to control and manage the operation and administration of the Plan.

  • Plan Fiduciary As defined in Section 5.3(o).

  • 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.

  • Appeals Committee means a Committee or Tribunal duly appointed by by-law to conduct hearings under this By-law;

  • Plan Administrator means the plan administrator described in Article 8.

  • Independent Fiduciary means an independent fiduciary who will serve as a fiduciary to the Plan in accordance with Article 3 that has no relationship or interest in any of the Settling Parties and is mutually agreed to by the Settling Parties.

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

  • 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.

  • Administrative Committee means the committee in charge of Plan administration, as described in Article VII.

  • Benefits Committee means the Employee Benefits Committee of Textron.

  • Appeals Board means the commissioners and deputy commissioners of the Workers’ Compensation Appeals Board acting en banc, in panels, or individually.

  • Grievance Committee means the Grievance Committee of the Bar.

  • 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 Agent means Kurtzman Carson Consultants LLC.

  • Review Committee or “Committee” means a committee established pursuant to rule Chapter 67-60, F.A.C.

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

  • Claims Officer means the individual or individuals appointed by the Monitor pursuant to the Amended Claims Procedure Order;

  • Retirement Committee means a committee consisting of the Company’s Vice President of Human Resources, the Director of HR Operations and the Compensation & Benefits Manager.

  • Claims Process means the process for Settlement Class Members’ submission of Claims, as described in Section III.

  • Appeals Tribunal or “AT” means the Body responsible for hearing and determining appeals set out in section 9;

  • Plan Committee means a committee of two or more directors appointed by the Board to administer the Plan.

  • Review Panel means a panel responsible for determining whether a reasonable basis exists for finding a violation of BSEF Rules, and for authorizing the issuance of notices of chargers against Persons alleged to have committed violations if the Review Panel believes that the matter should be adjudicated.

  • Claimant means a person who believes that he or she is being denied a benefit to which he or she is entitled hereunder.

  • 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.

  • independent review committee means the independent review committee of the investment fund established under National Instrument 81-107 Independent Review Committee for Investment Funds;

  • Fiduciaries means professional firms such as auditors, accountancy firms, law firms, analysts, insolvency professional entities, consultants, banks etc., assisting or advising the Company.