Common use of Claims Practices Clause in Contracts

Claims Practices. The Company is responsible for the investigating, contesting, compromising or litigating any Reinsured Policy claims in accordance with applicable law and policy terms. It is the Company’s sole decision to determine whether to investigate, contest, compromise or litigate a claim. The Company acknowledges that it follows industry standard and investigates claims with any of the following criteria: a) If the claim occurs within the contestable period as defined by the Reinsured Policy; or b) If there is a reasonable question regarding the validity of the insured’s death or the authenticity of the proofs of death; or c) If the death occurs outside the United States or Canada; or d) If the insured is missing or presumed dead; or e) If there is a reasonable suspicion of fraud. A claim investigation generally includes confirming proof of death, medical records to validate the insured’s medical disclosures and, if material, financial condition at the time of Policy application. Investigations may also include obtaining police reports, coroner’s reports, financial records, or other information that would be appropriate under the circumstances. The Company acknowledges that it does defend against claims meeting the following criteria: f) If a material misrepresentation is found in the Policy application; or g) If fraud is found; or h) If there is insufficient proof of death.

Appears in 3 contracts

Sources: Reinsurance Agreement (Nationwide VL Separate Account-G), Reinsurance Agreement (Nationwide VL Separate Account-G), Reinsurance Agreement (Thrivent Variable Life Account I)

Claims Practices. The Company is responsible for the investigating, contesting, compromising or litigating any Reinsured Policy claims in accordance with applicable law and policy terms. It is the Company’s sole decision to determine whether to investigate, contest, compromise or litigate a claim; however, the Company is responsible for investigating, contesting, compromising or litigating Reinsured Policy claims in accordance with applicable law and policy terms. The Company acknowledges that it follows industry standard standards and investigates claims with any of the following criteria: a) If the claim occurs within the contestable period as defined by the Reinsured Policy; or b) If there is a reasonable question regarding the validity of the insured’s death or the authenticity of the proofs of death; or c) If the death occurs outside the United States or Canada; or d) If the insured is missing or presumed dead; or e) If there is a reasonable suspicion of fraud. A claim investigation generally includes confirming proof of death, medical records to validate the insured’s medical disclosures and, if material, financial condition at the time of Policy application. Investigations may also include obtaining police reports, coroner’s reports, financial records, or other information that would be appropriate under the circumstances. The Company acknowledges that it does defend against claims meeting the following criteria: f) If a material misrepresentation is found in the Policy application; or g) If fraud is found; or h) If there is insufficient proof of death.

Appears in 2 contracts

Sources: Automatic Yrt Reinsurance Agreement (First Investors Life Level Premium Variable Lif Ins Sep Ac B), Reinsurance Agreement (Thrivent Variable Life Account I)

Claims Practices. The Company is responsible for the investigating, contesting, compromising or litigating any Reinsured Policy claims in accordance with applicable law and policy terms. It is the Company’s 's sole decision to determine whether to investigate, contest, compromise or litigate a claim. The Company acknowledges that it follows industry standard and investigates claims with any of the following criteria: a) If the claim occurs within the contestable period as defined by the Reinsured Policy; or b) If there is a reasonable question regarding the validity of the insured’s 's death or the authenticity of the proofs of death; or c) If the death occurs outside the United States or Canada; or d) If the insured is missing or presumed dead; or e) If there is a reasonable suspicion of fraud. A claim investigation generally includes confirming proof of death, medical records to validate the insured’s 's medical disclosures and, if material, financial condition at the time of Policy application. Investigations may also include obtaining police reports, coroner’s 's reports, financial records, or other information that would be appropriate under the circumstances. The Company acknowledges that it does defend against claims meeting the following criteria: f) If a material misrepresentation is found in the Policy application; or g) If fraud is found; or h) If there is insufficient proof of death.

Appears in 1 contract

Sources: Reinsurance Agreement (Nationwide VLI Separate Account-7)