Decision on Review definition

Decision on Review. A decision on the review of a claim denied in whole or in part shall be made in the following manner: (1) The decision on review shall be made by the Plan Administrator, which shall consider the application and any written materials submitted by the Claimant in connection therewith. The Plan Administrator, in its sole discretion, may require the Claimant to submit such additional documents or evidence as the Plan Administrator may deem necessary or advisable in making such review. (2) The Plan Administrator will render a decision upon a review of a denied claim within sixty days after receipt of a request for review. If special circumstances (such as the need to hold a hearing on any matter pertaining to the denied claim) warrant additional time, the decision will be rendered as soon as possible, but not later than one hundred twenty days after receipt of a request for review. Written notice of any such extension will be furnished to the Claimant prior to the commencement of the extension. (3) The decision on review shall be in writing and shall include specific reasons for the decision, written in a manner calculated to be understood by the Claimant, and specific references to the provisions of this Agreement on which the decision is based. The decision of the Plan Administrator on review shall be final and conclusive upon all persons. If the decision on review is not furnished to the Claimant within the time limits prescribed in subparagraph (c)(2) above, the claim will be deemed denied on review.
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Decision on Review. A decision on the review of a claim denied in whole or in part shall be made in the following manner: (1) The decision on review shall be made by the Plan Administrator, which shall consider the application and any written materials submitted by the Claimant in connection therewith. The Plan Administrator, in its sole discretion, may require the Claimant to submit such additional documents or evidence as the Plan Administrator may deem necessary or advisable in making such review. (2) The Plan Administrator will render a decision upon a review of a denied claim within sixty days after receipt of a request for review. If special circumstances (such as the need to hold a hearing on any matter pertaining to the denied claim) warrant additional time, the decision will be rendered as soon as possible, but not later than one hundred twenty days after receipt of a request for review. Written notice of any such extension will be furnished to the Claimant prior to the commencement of the extension. (3) The decision on review shall be in writing and shall include specific reasons for the decision, written in a manner calculated to
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Decision on Review. A decision on the review of a claim denied in whole or in part shall be made in the following manner: (i) The decision on review shall be made by the Plan Administrator, which shall consider the application and any written materials submitted by the Claimant in connection therewith. The Plan Administrator, in its sole discretion, may require the Claimant to submit such additional documents or evidence, as the Plan Administrator may deem necessary or advisable in making such review. (ii) The Plan Administrator will render a decision upon a review of a denied claim within sixty (60) days after receipt of a request for review. If special circumstances (such as the need to hold a hearing on any matter pertaining to the denied claim) warrant additional time, the decision will be rendered as soon as possible, but not later than one hundred twenty (120) days after receipt of a request for review. Written notice of any such extension will be furnished to the Claimant prior to the commencement of the extension. (iii) The decision on review shall be in writing and shall include specific reasons for the decision, written in a manner calculated to be understood by the Claimant, and the specific references to the provisions of this Agreement or to the Collateral Assignment on which the decision is based. The decision of the Plan Administrator on review shall be final and conclusive upon all persons. If the decision on review is not furnished to the Claimant within the time limits prescribed in subparagraph (ii) above, the claim will be deemed denied on review.
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Examples of Decision on Review in a sentence

  • Upon termination or expiration of this Agreement or an Order Form, all Software licenses and rights to use Confidential Information that are granted thereunder shall terminate and the rights shall immediately and automatically fall back to Delphix.

  • DIRECTION It is directed that the Regional Director for Region 32 shall, within 14 days of this Decision on Review and Direction, open and count the impounded ballots cast by the employees in the petitioned-for unit, prepare and serve on the parties a tally of ballots, and thereafter issue the appropriate certification.

  • The Plan Administrator may require the applicant to submit additional facts, documents or other material as he or she may find necessary or appropriate in making his or her review.Section 8.04 Decision on Review.

  • In the Decision on Review of the Law on OJK, the Constitutional Court interpreted the word independent as freedom to achieve the goals set out in the Law and to take decisions to achieving its objectives without intervention by the government or the branches of state power (see Constitutional Court Decision No. 25/PUU-XII/2014, pg 289).

  • See, e.g., Decision on Review in Michael Gold, 115 IBLA 218 at *2 (1991) (discussing the Board’s “usual practice” of remanding inadequate EAs for supplementation).

  • Decision on Review of an Adverse Benefit Determination The Committee will make a decision within a reasonable period of time, but no later than 60 days after its receipt of your request for review.

  • Explanatory Note: The Authority has waived the above registration requirements for certain generation facilities of non-contestable consumers pursuant to the Authority’s Assessment and Decision on Review of Policy on Generation with less than 1MW in Installed Capacity published on 28 February 2011.

  • A sentence in a criminal case that (A) is outside the standard range for the offense, (B) the state or local government believes involves a miscalcula- tion of the standard range, (C) includes provisions that are unauthorized by law, or (D) omits a provision that is required by law.(c) Superior Court Decision on Review of Decision of Court of Limited Jurisdiction.

  • Applicant made this same argument before the Committee.20 The Fund, for its part, asks the Tribunal to confirm that the Committee did not err in determining that the order was “final and binding on the parties” within the meaning of the Section 11.3 Rules, at the time of the Committee’s Decision of March 10, 2016 and Decision on Review of August 24, 2016.

  • Notes about the individual Colleges (available on our VLE) contain a brief description of the College and list available facilities.


More Definitions of Decision on Review

Decision on Review. The decision on review of a claim denied in whole or in part by the Plan Administrator shall be made in the following manner: 16. 4.1 Within 60 days following receipt by the Committee of the request for review (or within 120 days if special circumstances require an extension of time), the Committee shall notify the claimant in writing of its decision with regard to the claim. In the event of such special circumstances requiring an extension of time, written notice of the extension shall be furnished to the claimant prior to the commencement of the extension. If the decision on review is not furnished in a timely manner, the claim shall be deemed denied as of the close of the initial 60-day period (or the close of the extension period, if applicable).
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Related to Decision on Review

  • Decision-maker means a person who makes a determination regarding responsibility after the investigation has concluded. The Decision-maker cannot be the same person as the Title IX Coordinator, the Investigator, or the Appellate Decision-maker.

  • Review means a financial or operational audit, investigation, inspection or other form of review requested or required by the Funder under the terms of the Enabling Legislation or this Agreement, but does not include the annual audit of the HSP’s financial statements;

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

  • Independent review organization means an entity that is accredited to conduct independent external reviews of adverse benefit determinations.

  • Professional Conduct Committee means the professional conduct committee established by the Council in terms of section 12(2)(b);

  • Supervisory Review means ongoing clinical case reviews in accordance with procedures developed by ADMINISTRATOR, to determine the appropriateness of Diagnosis and treatment and to monitor compliance to the minimum ADMINISTRATOR and Medi-Cal charting standards. Supervisory review is conducted by the program/clinic director or designee.

  • Decision means a determination, action, vote, or disposition upon a motion, proposal, recommendation, resolution, order, ordinance, bill, or measure on which a vote by members of a public body is required and by which a public body effectuates or formulates public policy.

  • Evaluation Team means the team appointed by the City; “Information Meeting” has the meaning set out in section 2.2;

  • Board of Review or “board” means the state building code board of review created by this chapter.

  • Expedited review means an examination, in accordance with

  • Architectural Review Committee or “ARC” shall mean the architectural review committee established by the Organization to review plans submitted to the Organization for architectural review.

  • Utilization review means the prospective (prior to), concurrent (during) or retrospective (after) review of any service to determine whether such service was properly authorized, constitutes a medically necessary service for purposes of benefit payment, and is a covered healthcare service under this plan. WE, US, and OUR means Blue Cross & Blue Shield of Rhode Island. WE, US, or OUR will have the same meaning whether italicized or not. YOU and YOUR means the subscriber or member enrolled for coverage under this agreement. YOU and YOUR will have the same meaning whether italicized or not.

  • NZOC Nomination and Selection Regulation means the regulation of NZOC relation to the nomination and selection Process for all Olympic and Commonwealth games, including the Games.

  • District Evaluation Advisory Committee means a group created to oversee and guide the planning and implementation of the Board of Education's evaluation policies and procedures as set forth in N.J.A.C. 6A:10-2.3.

  • 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.

  • Compliance Review means an inspection of the home, grounds, and files to determine compliance with these regulations.

  • ATTORNEY REVIEW The Purchaser acknowledges that Purchaser has had the opportunity to consult with its legal counsel regarding this Agreement and that accordingly the terms of this Agreement are not to be construed against any party because that party drafted this Agreement or construed in favor of any Party because that Party failed to understand the legal effect of the provisions of this Agreement.

  • Independent Safeguarding Authority is a non-departmental public body sponsored by the Home Office set up under the provisions of the Safeguarding Vulnerable Groups Act 2006 and which is responsible for the decision making and maintenance of two lists covering the children’s and vulnerable adults’ sectors

  • Periodic Review means a review conducted by Ofwat for the purpose of determining one or more Price Controls in accordance with Part III of Condition B, but so that references in Part IV of Condition B to a Periodic Review shall exclude any review carried out under paragraph 11 of that Condition and shall include the determination by the Competition and Markets Authority of the relevant questions or, as the case may be, the disputed determination referred to it under paragraph 16 of Condition B;

  • Appraisal review means the act or process of developing

  • Utilization review plan or "plan" means a written procedure for performing review.

  • Application Review Start Date means the later date of either the date on which the District issues its written notice that the Applicant has submitted a completed Application or the date on which the Comptroller issues its written notice that the Applicant has submitted a completed Application and as further identified in Section 2.3.A of this Agreement.

  • Performance Review means a summative evaluation of a teacher other than a beginning teacher and used to determine whether the teacher’s practice meets school district expectations and the Iowa teaching standards, and to determine whether the teacher’s practice meets school district expectations for career advancement in accordance with Iowa Code section 284.7.

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

  • Institutional Review Board or “IRB” means, in accordance with 45 C.F.R. Part 46, 21 C.F.R. part 56, and other applicable regulations, an independent body comprising medical, scientific, and nonscientific members, whose responsibility is to ensure the protection of the rights, safety, and well-being of the Human Subjects involved in a study.

  • Investigation Committee means the Investigation Committee appointed by the Board under Regulation 5 of these Regulations;