Common use of Claims Requiring a Determination of Disability Clause in Contracts

Claims Requiring a Determination of Disability. If the initial claim is for Disability benefits, and the claim requires an independent determination by the Plan Administrator of a Participant's Disability status, prior to such review of the denied claim, the Claimant shall be given, free of charge, any new or additional evidence considered, relied upon, or generated by the Plan, insurer, or other person making the benefit determination in connection with the claim, or any new or additional rationale, as soon as possible and sufficiently in advance of the date on which the notice of adverse benefit determination on review is required to be provided, to give the Claimant a reasonable opportunity to respond prior to that date.