Claims in Process Sample Clauses

The "Claims in Process" clause defines how claims that are pending or unresolved at a specific point in time—such as the end of a contract or policy period—will be handled. Typically, this clause outlines the procedures for submitting, reviewing, and resolving claims that have been initiated but not yet finalized, ensuring that both parties understand their rights and obligations regarding these outstanding matters. Its core function is to provide clarity and continuity in the management of claims, preventing disputes or confusion about responsibility for claims that straddle the end of an agreement.
Claims in Process. Upon termination of this Agreement for any reason other than the Company's breach, the Company shall continue to be authorized to provide recovery and auditing services with respect to all claims in process on the termination date. Claims are considered in the process if the Company or its third-party vendor has evaluated, screened, audited, or processed them, including all claims inventoried in Company's claim payment database.
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Claims in Process. Any claims made against insurers under the ---------------- Policies prior to the Distribution Date and unpaid as of such date shall be for the account of the party (i) whose asset after the Distribution Date is the basis for the claim, or (ii) in the case of a liability claim, which is the owner after the Distribution Date of the facility at which the activity which is the subject of the claim occurred or is alleged to have occurred. If the proceeds of the claim are received by a party other than the party entitled to receive such proceeds pursuant to this Section 1.01, such receiving party shall pay over such proceeds to such other party. In respect of claims under Policies for the account of LifePoint or Triad, in the event that any deductible, co- insurance or self-insured retention in respect of such claim has not been paid or accounted for prior to the Distribution Date, or if the Policy under which the claim was made provides for any aggregate deductible, co-insurance or self- insured retention or if the claim is not fully covered because the aggregate policy limits have been exhausted, such amounts shall be paid to such party by Columbia/HCA pursuant to the indemnification provided for in the Distribution Agreement.
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Claims in Process all claims that are in a pending status (data, medical, COB edits) and require review by a claim examiner prior to being released for adjudication. Because the final pay amount is unknown, the amounts are recorded at the billed amount
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Claims in Process. Any claims made against insurers under the ----------------- Documents prior to the Distribution Date and unpaid as of such date shall be for the account of the party whose asset after the Distribution Date is the basis for the claim. For the purposes of this Agreement, a Leased Facility shall be deemed to be a New Hillhaven asset, and with regard to such Leased Facilities, New Hillhaven shall be deemed to be "the party whose asset is the basis of the claim." If the Proceeds of the claim are received by a party other than the party entitled to receive such proceeds pursuant to this Section 1.01, such receiving party shall pay over such proceeds to such other party. In the event that any deductible, co-insurance or self-insured retention in respect of such claim has not been paid or accounted for prior to the Distribution Date, it shall be charged to the account of the party entitled to receive or who receives the benefit of the claim payment; provided, however, that if the Document under -------- ------- which the claim was made provides for any aggregate deductible, co-insurance or self-insured retention or if the claim is not fully covered because the aggregate policy limits have been exhausted, the allocation of payments under such Document shall be reallocated in accordance with the procedure shown in Schedule 1.03(c).
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Related to Claims in Process

  • Move-In Procedure The Resident must follow all move-in times, dates and procedures outlined by the Manager. The Resident will be notified of the date and time that the Resident may move into the Room. If the Resident wishes to move-in prior to the scheduled move-in day, the Resident may do so at the Manager’s then posted nightly rate and subject to availability (detailed in Table 1 & 3). Care is to be exercised in moving-in heavy objects to avoid damage to floor coverings, walls, doors and frames and any other part of the Residence. The Resident shall be responsible to pay forthwith to the Manager the cost of any damage to the Room or the Residence arising from the move-in.

  • Disputed Claims 4.1 Notwithstanding paragraph 4.5 of this Schedule, payment by the Authority of all or any part of any invoice rendered or other claim for payment by the Contractor shall not signify approval of such invoice/claim. The Authority reserves the right to verify invoices/claims after the date of payment and subsequently to recover any sums which have been overpaid. 4.2 If any part of a claim rendered by the Contractor is disputed or subject to question by the Authority either before or after payment then the Authority may call for the Contractor to provide such further documentary and oral evidence as it may reasonably require to verify its liability to pay the amount which is disputed or subject to question and the Contractor shall promptly provide such evidence in a form satisfactory to the Authority. 4.3 If any part of a claim rendered by the Contractor is disputed or subject to question by the Authority, the Authority shall not withhold payment of the remainder. 4.4 If any invoice rendered by the Contractor is paid but any part of it is disputed or subject to question by the Authority and such part is subsequently agreed or determined not to have been properly payable then the Contractor shall forthwith repay such part to the Authority. 4.5 The Authority shall be entitled to deduct from sums due to the Contractor by way of set-off any amounts owed to it or which are in dispute or subject to question either in respect of the invoice for which payment is being made or any previous invoice.

  • Maintenance of PMI Policy; Claims With respect to each Mortgage Loan with a loan-to-value ratio in excess of 80% for which a PMI Policy is both required and has been issued, the Servicer shall, to the extent permitted by Accepted Servicing Practices, maintain or cause the Mortgagor to maintain in full force and effect a PMI Policy insuring that portion of the Mortgage Loan in excess of 75% of value, and shall cause the Mortgagor to pay the premium thereon on a timely basis, until the loan-to-value ratio of such Mortgage Loan is reduced to 80% or PMI can otherwise no longer be mandated pursuant to applicable law. In the event that such PMI Policy shall be terminated, the Servicer shall attempt to obtain from another Qualified Insurer a comparable replacement policy, with a total coverage equal to the remaining coverage of such terminated PMI Policy. The Servicer shall not take any action which would result in noncoverage under any applicable PMI Policy of any loss which, but for the actions of the Servicer would have been covered thereunder. In connection with any assumption or substitution agreement entered into or to be entered into pursuant to this Agreement, the Servicer shall promptly notify the insurer under the related PMI Policy, if any, of such assumption or substitution of liability in accordance with the terms of such PMI Policy and shall take all actions which may be required by such insurer as a condition to the continuation of coverage under such PMI Policy. If such PMI Policy is terminated as a result of such assumption or substitution of liability, the Servicer shall obtain a replacement PMI Policy as provided above. With respect to each Mortgage Loan covered by a PMI Policy or LPMI Policy, the Servicer shall take all such actions on behalf of the Owner as are necessary to service, maintain and administer the related Mortgage Loan in accordance with such Policy and to enforce the rights under such Policy. Except as expressly set forth herein, the Servicer shall have full authority on behalf of the Owner to do anything it deems appropriate or desirable in connection with the servicing, maintenance and administration of such Policy; provided that the Servicer shall not take any action to permit any modification or assumption of a Mortgage Loan covered by a LPMI or PMI Policy, or take any other action with respect to such Mortgage Loan, which would result in non-coverage under such Policy of any loss which, but for actions of the Servicer, would have been covered thereunder. The Servicer shall cooperate with the PMI insurers and shall furnish all reasonable evidence and information in the possession of the Servicer to which the Servicer has access with respect to the related Mortgage Loan. The Servicer agrees to prepare and present, on behalf of itself and the Owner, claims to the insurer under any PMI Policy or LPMI Policy in a timely fashion in accordance with the terms of such PMI Policy or LPMI Policy and, in this regard, to take such action as shall be necessary to permit recovery under any PMI Policy or LPMI Policy respecting a defaulted Mortgage Loan. Pursuant to Section 3.04, any amounts collected by the Servicer under any PMI Policy or LPMI Policy shall be deposited in the Collection Account, subject to withdrawal pursuant to Section 3.05.

  • Submitting False Claims The full text of San Francisco Administrative Code Chapter 21, Section 21.35, including the enforcement and penalty provisions, is incorporated into this Agreement. Pursuant to San Francisco Administrative Code §21.35, any contractor or subcontractor who submits a false claim shall be liable to the City for the statutory penalties set forth in that section. A contractor or subcontractor will be deemed to have submitted a false claim to the City if the contractor or subcontractor: (a) knowingly presents or causes to be presented to an officer or employee of the City a false claim or request for payment or approval;

  • Assistance in Proceedings Seller will cooperate with Buyer and its counsel in the contest or defense of, and make available its personnel and provide any testimony and access to its books and Records in connection with, any Proceeding involving or relating to (a) any Contemplated Transaction or (b) any action, activity, circumstance, condition, conduct, event, fact, failure to act, incident, occurrence, plan, practice, situation, status or transaction on or before the Closing Date involving Seller, the Business, or the Assets.