Amount, Duration and Scope of Coverage Clause Samples

The "Amount, Duration and Scope of Coverage" clause defines the specific limits, timeframes, and circumstances under which insurance or other coverage applies within an agreement. It typically outlines the maximum monetary amount covered, the period during which the coverage is effective, and the types of risks or events included or excluded. This clause ensures that all parties clearly understand the extent and limitations of the coverage, thereby reducing ambiguity and potential disputes regarding protection under the contract.
Amount, Duration and Scope of Coverage. Contractor shall comply with the terms of 42 C.F.R. §438.206(b) and provide or arrange to have provided to all Enrollees services described in 89 Ill. Adm. Code, Part 140 as amended from time to time and not specifically excluded therein in accordance with the terms of this Contract. Covered Services shall be provided in the amount, duration and scope as set forth in 89 Ill. Adm. Code, Part 140 and this Contract, and shall be sufficient to achieve the purposes for which such Covered Services are furnished. This duty shall commence at the time of initial coverage as to each Enrollee. Contractor shall, at all times, cover the appropriate level of service for all Emergency Services and non-Emergency Services in an appropriate setting. Contractor shall notify Department in writing as soon as practicable, but no later than five (5) days, following a change in Contractor’s network of Affiliated Providers that renders Contractor unable to provide one (1) or more Covered Services within the access to care standards set forth in Section 5.6. Contractor shall not refer Enrollees to publicly supported health care entities to receive Covered Services for which Contractor receives payment from the Department, unless such entities are Affiliated Providers with Contractor. Such publicly supported health care entities include, but are not limited to, Chicago Department of Public Health and its clinics, Cook County Bureau of Health Services, and Certified Local Health Departments. Contractor shall provide a mechanism for an Enrollee to obtain a second opinion from a qualified Provider, whether Affiliated or non-Affiliated, at no cost to the Enrollee. Contractor will assist in coordinating obtaining any second opinion from a non-Affiliated Provider. Covered Services will be phased in as three
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Related to Amount, Duration and Scope of Coverage

  • Minimum scope of coverage Commercial general coverage shall be at least as broad as Insurance Services Office Commercial General Liability occurrence form CG 0001 (ed. 11/88) or Insurance Services Office form number GL 0002 (ed. 1/73) covering comprehensive General Liability and Insurance Services Office form number GL 0404 covering Broad Form Comprehensive General Liability. Automobile coverage shall be at least as broad as Insurance Services Office Automobile Liability form CA 0001 (ed. 12/90) Code 1 (“any auto”). No endorsement shall be attached limiting the coverage.

  • Scope of Coverage 1. This Section shall apply to an investment dispute between a Member State and an investor of another Member State that has incurred loss or damage by reason of an alleged breach of any rights conferred by this Agreement with respect to the investment of that investor. 2. A natural person possessing the nationality or citizenship of a Member State shall not pursue a claim against that Member State under this Section. 3. This Section shall not apply to claims arising out of events which occurred, or claims which have been raised prior to the entry into force of this Agreement. 4. Nothing in this Section shall be construed so as to prevent a disputing investor from seeking administrative or judicial settlement available within the country of a disputing Member State.

  • Duration and Scope of Covenants If any court or other decision-maker of competent jurisdiction determines that any of the Executive’s covenants contained in this Agreement, including, without limitation, any of the Restrictive Covenants, or any part thereof, is unenforceable because of the duration or geographical scope of such provision, then, after such determination has become final and unappealable, the duration or scope of such provision, as the case may be, shall be reduced so that such provision becomes enforceable and, in its reduced form, such provision shall then be enforceable and shall be enforced.

  • Effective Date of Coverage An eligible employee is entitled to benefits provided he is actively at work on the first day the Long Term Disability Benefit Plan becomes effective. An eligible employee absent from work due to sickness or accident at the effective date of the Plan, shall only be eligible for Long Term Disability Plan benefits upon the return to continuous active full-time employment for a period of more than four consecutive weeks. The Company shall have the right to give medical examinations to employees returning from such lay-off to determine their eligibility under the Plan.

  • Duration of Coverage Consultant shall procure and maintain for the duration of the Agreement insurance against claims for injuries to persons or damages to property, which may arise from or in connection with the performance of the Services hereunder by Consultant, his/her agents, representatives, employees or subconsultants.