Common use of Application for Review Clause in Contracts

Application for Review. (i) If a claimant wishes to request a review of the decision denying his claim to benefits under this Agreement, other than a claim described in paragraph (ii) of this Section 3(e), then he must submit the written application to the Claims Administrator within sixty (60) days after receiving written notice of the denial. (ii) If the claimant wishes to request a review of the decision denying his claim to benefits under this Agreement due to the Executive becoming Substantially Disabled, then he must submit the written application to the Appeals Fiduciary within one hundred eighty (180) days after receiving written notice of the denial. With respect to any such claim, in deciding an appeal of any denial based in whole or in part on a medical judgment (including determinations with respect to whether a particular treatment, drug, or other item is experimental, investigational, or not medically necessary or appropriate), the Appeals Fiduciary shall: (1) consult with a health care professional who has appropriate training and experience in the field of medicine involved in the medical judgment; and (2) identify the medical and vocational experts whose advice was obtained on behalf of this Agreement in connection with the denial without regard to whether the advice was relied upon in making the determination to deny the claim. Notwithstanding the foregoing, the health care professional consulted pursuant to this Section 3(e) shall be an individual who (A) was not consulted with respect to the initial denial of the claim that is the subject of the appeal and (B) is not a subordinate of such previously consulted individual.

Application for Review. (i) If a claimant wishes to request a review of the decision denying his or her claim to benefits under this Agreement, other than a claim described in paragraph (ii) of this Section 3(esection 4(e), then he or she must submit the written application to the Claims Administrator within sixty (60) days after receiving written notice of the denial. (ii) If the claimant wishes to request a review of the decision denying his or her claim to benefits under this Agreement due to the Executive becoming Substantially Disabled, then he or she must submit the written application to the Appeals Fiduciary within one hundred eighty (180) days after receiving written notice of the denial. With respect to any such claim, in deciding an appeal of any denial based in whole or in part on a medical judgment (including determinations with respect regard to whether a particular treatment, drug, or other item is experimental, investigational, or not medically necessary or appropriate), the Appeals Fiduciary shall: (1) consult with a health care professional who has appropriate training and experience in the field of medicine involved in the medical judgment; and (2) identify the medical and vocational experts whose advice was obtained on behalf of this Agreement in connection with the denial without regard to whether the advice was relied upon in making the determination to deny the claim. Notwithstanding the foregoing, the health care professional consulted pursuant to this Section 3(esection 4(e) shall be an individual who (A) was not consulted with respect to the initial denial of the claim that is the subject of the appeal and (B) is not or a subordinate of such previously consulted individual.

Application for Review. (ia) If a claimant wishes to request a review of the decision denying his claim to benefits under this the Agreement, other than a claim described in paragraph clause (iib) of this Section 3(e)8.1.4, then he must submit the written application to the Claims Administrator Company within sixty (60) days after receiving written notice of the denial. (iib) If the claimant wishes to request a review of the decision denying his claim to benefits under this the Agreement due to the Executive becoming Substantially DisabledExecutive’s Disability, then he must submit the written application to the Appeals Fiduciary within one hundred eighty (180) days after receiving written notice of the denial. With respect to any such claim, in deciding an appeal of any denial based in whole or in part on a medical judgment (including determinations with respect regard to LOWCOUNTRY NATIONAL BANK Executive Deferred Compensation Agreement whether a particular treatment, drug, or other item is experimental, investigational, or not medically necessary or appropriate), the Appeals Fiduciary shall: (1i) consult with a health care professional who has appropriate training and experience in the field of medicine involved in the medical judgment; and (2ii) identify the medical and vocational experts whose advice was obtained on behalf of this the Agreement in connection with the denial without regard to whether the advice was relied upon in making the determination to deny the claim. Notwithstanding the foregoing, the health care professional consulted pursuant to this Section 3(eclause (b) shall be an individual who (A) was not consulted with respect to the initial denial of the claim that is the subject of the appeal and (B) is not or a subordinate of such previously consulted individual.

Application for Review. (i) If a claimant wishes to request a review of the decision denying his or her claim to benefits under this Agreement, other than a claim described in paragraph (ii) of this Section 3(e6.2(e)(ii), then he or she must submit the written application to the Claims Administrator within sixty (60) days after receiving written notice of the denial. (ii) If the claimant wishes to request a review of the decision denying his or her claim to benefits under this Agreement due to the Executive Officer becoming Substantially Disabledsubject to a Disability, then he or she must submit the written application to the Appeals Fiduciary within one hundred eighty (180) days after receiving written notice of the denial. With respect to any such claim, in deciding an appeal of any denial based in whole or in part on a medical judgment (including determinations with respect regard to whether a particular treatment, drug, or other item is experimental, investigational, or not medically necessary or appropriate), the Appeals Fiduciary shall: (1) consult with a health care professional who has appropriate training and experience in the field of medicine involved in the medical judgment; and (2) identify the medical and vocational experts whose advice was obtained on behalf of this Agreement in connection with the denial without regard to whether the advice was relied upon in making the determination to deny the claim. Notwithstanding the foregoing, the health care professional consulted pursuant to this Section 3(esection 6.2(e)(ii) shall be an individual who (A) was not consulted with respect to the initial denial of the claim that is the subject of the appeal and (B) is not or a subordinate of such previously consulted individual.