CLAIMS REQUIREMENTS Sample Clauses
CLAIMS REQUIREMENTS. The insurer will pay benefits provided that:
1. the insured person has contacted MSH International and received pre-authorization for any costs to be incurred as an in-patient. In an emergency when MSH International cannot be contacted in advance, then the admission to hospital must be reported as soon as possible and in any event not later than forty-eight (48) hours after admission.
2. written details of all claims have been sent to the MSH International as soon as possible and in any event not later than ninety (90) days from the beginning of the medical treatment.
3. all documentation relating to the claimincluding the claimform and accounts are originals and not copies.
4. the required premium has been paid relative to the insured person making the claim. It is understood that:
1. the insurer can ask for medical information fromany physician or surgeon as often as required;
2. the insurer shall be notified of any circumstances that may lead to a claim against a third party or any other insurance; and
3. in the case of a claimin the insured person’s home country, proof of the insured person’s entry date into their home country is provided. ▇▇, ▇▇▇ ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇ Clichy cedex, FRANCE E Shan Rd, Shanghai, CHINA, 200127
CLAIMS REQUIREMENTS. For (i) all non-contestable claims whether facultative or automatic and (ii) all contestable claims covered by automatic reinsurance with a total death benefit less than or equal to [dollar amount], the Ceding Company will review and settle such claims without prior approval from or consultation with the Reinsurer.
CLAIMS REQUIREMENTS. What am I insured for? In the event of your death, London Life will which you are insured as described in the pay the amount of life insurance for Proceeds will be paid in one lump sum unless you or a beneficiary requests, by written notice filed with London Life, one of the following alternate payment methods: proceeds left on deposit; or proceeds paid in instalments; under any settlement plan then available from London Life. Life insurance If you are insured as a member of this group for long term disability insurance with London Life and, prior to your 65th birthday: you become, as a result of injury or disease, totally disabled as in the long term disability insurance benefit; and the disability has existed for shorter waiting period under or If you are not insured as a member with London Life and, prior to waiting period of six months or a disability benefit; for long term disability insurance you become, as a result of injury or disease, totally disabled and are unable to do any work; and the disability has existed for a continuous waiting period of six months; your life insurance will continue without payment of premium from the date your disability started and during the continuance of your disability, but not beyond age
CLAIMS REQUIREMENTS. The Ceding Company will promptly notify the Reinsurer after it receives a claim on a policy reinsured under this LOI. The Ceding Company will review and settle claims without prior approval from the Reinsurer. The Ceding Company may consult with the Reinsurer, but ultimate authority to pay or deny a claim will rest solely with the Ceding Company, and failure to follow the Reinsurer's recommendation, if any, will not relieve the Reinsurer of its reinsurance liability. For (i) contestable claims covered by facultative reinsurance regardless of amount and (ii) claims (whether contestable or non-contestable) in excess of [dollar amount] in which the death of the insured occurred in a country other than the United States (including territories and possessions) or Canada, the Ceding Company will send the Reinsurer full underwriting and claims investigation information along with proof of payment by the Ceding Company. For all other claims, the Ceding Company will provide the Reinsurer with proper claim proofs, which are a copy of the proof of payment by the Ceding Company, a copy of the insured's death certificate and a copy of the claimant's statement. The Ceding Company's contractual liability for policies covered under this LOI is binding on the Reinsurer, provided that the claim was paid in good faith and the company's standard practices were followed in the adjudication of the claim. Notwithstanding the foregoing, the Reinsurer retains the right upon reasonable notice to request and receive all reasonably necessary documents in connection with any claim. Claims covered under this LOI shall be paid within 30 calendar days of receipt of proper claim proofs or, when requested, within 30 calendar days of receipt of all requested documents in connection with a claim. Reinsurer assures Ceding Company that such requests for additional documents prior to payment of any claim will be made only occasionally and not routinely unless warranted by factors such as suspected fraud or other identifiable concerns. The Ceding Company will promptly advise the Reinsurer of its intention to contest, compromise, or litigate any claim involving a reinsured policy. Unless the Reinsurer does not accept participation in such contest, compromise, or litigation, the Reinsurer will pay its share of any settlement or decision up to the maximum that would have been payable under the specific policy had there been no controversy. If the Reinsurer does not accept participation in such cont...
CLAIMS REQUIREMENTS. Replace the first paragraph with the following:
CLAIMS REQUIREMENTS. LICENSEE will amend any patent application to include claims required by REGENTS.
CLAIMS REQUIREMENTS o Claims Data Management o On Line access to policy coverage information to the claims TPA's o Data for calculating claims TPA's processing fees
CLAIMS REQUIREMENTS. The insurer will pay benefits provided that:
1. the insured person has contacted EBA and received pre-authorization for any costs to be incurred as an in-patient. In an emergency when EBA cannot be contacted in advance, then the admission to hospital must be reported as soon as possible and in any event not later than forty-eight (48) hours after admission.
2. written details of all claims have been sent to the EBA as soon as possible and in any event not later than ninety (90) days from the beginning of the medical treatment.
3. all documentation relating to the claimincluding the claimform and accounts are originals and not copies.
4. the required premium has been paid relative to the insured person making the claim. It is understood that:
1. the insurer can ask for medical information fromany physician or surgeon as often as required;
2. the insurer shall be notified of any circumstances that may lead to a claim against a third party or any other insurance; and
3. in the case of a claimin the insured person’s home country, proof of the insured person’s entry date into their home country is provided. All pertinent information must be sent to: ▇▇, ▇▇▇ ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇ Clichy cedex, FRANCE
CLAIMS REQUIREMENTS tort claims excluded
(a) The claim shall be in writing and include the documents necessary to substantiate the claim. Claims must be filed on or before the date of final payment. Nothing in this subdivision is intended to extend the time limit or supersede notice requirements otherwise provided by contract for the filing of claims.
(1) For claims of less than fifty thousand dollars ($50,000), the local agency shall respond in writing to any written claim within 45 days of receipt of the claim, or may request, in writing, within 30 days of receipt of the claim, any additional documentation supporting the claim or relating to defenses to the claim the local agency may have against the claimant.
(2) If additional information is thereafter required, it shall be requested and provided pursuant to this subdivision, upon mutual agreement of the local agency and the claimant.
(3) The local agency's written response to the claim, as further documented, shall be submitted to the claimant within 15 days after receipt of the further documentation or within a period of time no greater than that taken by the claimant in producing the additional information, whichever is greater.
(1) For claims of over fifty thousand dollars ($50,000) and less than or equal to three hundred seventy-five thousand dollars ($375,000), the local agency shall respond in writing to all written claims within 60 days of receipt of the claim, or may request, in writing, within 30 days of receipt of the claim, any additional documentation supporting the claim or relating to defenses to the claim the local agency may have against the claimant.
(2) If additional information is thereafter required, it shall be requested and provided pursuant to this subdivision, upon mutual agreement of the local agency and the claimant.
(3) The local agency's written response to the claim, as further documented, shall be submitted to the claimant within 30 days after receipt of the further documentation, or within a period of time no greater than that taken by the claimant in producing the additional information or requested documentation, whichever is greater.
(d) If the claimant disputes the local agency's written response, or the local agency fails to respond within the time prescribed, the claimant may so notify the local agency, in writing, either within 15 days of receipt of the local agency's response or within 15 days of the local agency's failure to respond within the time prescribed, respectively, and dema...