Your representative definition

Your representative means an individual who has been authorized by you to file a grievance or a complaint on your behalf.

Your representative means an individual who has been authorized by you to file an appeal or a complaint on your behalf.

Your representative means the person duly authorised by you to act on your behalf for the purposes of the Agreement and identified to us by you under Clause 4.2.

Examples of Your representative in a sentence

• If We have denied coverage on the basis that a service is not Medically Necessary (including appropriateness, health care setting, level of care or effectiveness of a Covered benefit); or is an experimental or investigational treatment (including clinical trials and treatments for rare diseases), You or Your representative may appeal that decision to an External Appeal Agent, an independent third party certified by the State to conduct these appeals.

• If any payment meant for Us in any form is paid to an insurance agent then such payment is made at Your risk and the agent will be acting only as Your representative.

• We, upon receipt of a notice of claim, will furnish Your representative with such forms as We may require for filing proofs of loss.

• Payment of any Benefit will only be considered if You have complied with all the terms and conditions of this policy, and if You or Your representative have complied with all the requirements of the claims process as detailed below.

• Your representative or representative’s firm may charge you a sales charge, commission or service fee.

More Definitions of Your representative

Your representative means an individual who has been authorized by you to file an appeal or a complaint on your behalf. If a coverage decision results in non-coverage of a health care service including non-payment of all or any part of your claim, you, your representative, or your health care provider acting on your behalf, have a right to file an appeal within one hundred eighty (180) calendar days of receipt of the coverage decision. The appeal may be submitted verbally or in writing and should include any information you, your representative or a health care provider acting on your behalf believe will help us review your appeal. You, your representative or a health care provider acting on your behalf may call the phone number listed on your identification card to verbally submit your appeal. Send the written appeal to: UnitedHealthcare Appeals & Grievance PO Box 6111 Mail Stop CA-0197 Cypress, CA 90630 We will render a final decision in writing within 60 calendar days after the date on which the appeal is filed. We will send you, your representative and your health care provider acting on your behalf, a written notice, within 30 days, of the appeal decision. If upheld, the notice of an appeal decision will include the following: • Details concerning the specific factual basis for the decision in clear, understandable language; • The right for you, your representative, or a health care provider acting on your behalf, to file a complaint with the Insurance Commissioner within four months of receipt of our appeal decision; • The Insurance Commissioner’s address, telephone number and fax number; • A statement that the Health Advocacy Unit is available to assist you in filing a complaint with the Insurance Commissioner; and • The information shown below regarding assistance from the Health Advocacy Unit. If you are dissatisfied with the outcome of the appeal, you, your representative or a health care provider acting on your behalf may file a complaint with the Life and Health Complaint Unit, Maryland Insurance Administration, within four months after receipt of the appeal decision. You, your representative or a health care provider acting on your behalf may contact the Maryland Insurance Administration Consumer Complaint Investigation Life and Health/Appeals and Grievance, at 000 Xx. Xxxx Xxxxx, Suite 2700, Baltimore, MD 21202, phone (000) 000-0000, toll free (800) 492- 6116 or facsimile (000) 000-0000. The Insurance Commissioner may request that you, your representative or a h...

Your representative means the person nominated in Item A7 of Schedule 1 to this Deed or as otherwise Notified to You by Us.

Your representative means the person duly authorised by you to act on your behalf for the purposes of the Agreement and identified to us by you under Clause 4.2; and

Your representative means the person named in Schedule 1 as amended by You from time to time by You by notice in writing to UCOL Limited.

Your representative means the person You nominate to be authorised to act on behalf of You to manage Your account, including ordering of additional (or varying the amount of) Services, including any options, and starting and terminating any Service.

Your representative means the representative you nominate in the Proposal, or as notified to us from time to time.

Your representative means Your representative specified in the Details.