Common use of Determining Eligibility Clause in Contracts

Determining Eligibility. 6 1. The Claims Administrator shall make the determination as to 7 whether a claim form is complete. If it is not complete, the Claims Administrator shall 8 request additional information from the claimant, if it appears that such additional 9 information would complete the claim form. Such requests for information shall be in 10 writing and shall specify the information necessary to complete the claim form. The 11 requests for information will be sent via first class mail, printed in English and Spanish, 12 and inform the claimant that a response must be returned no later than forty-five (45) 13 days from the date the request for information was mailed. The claimant must provide 14 the requested information, signed under penalty of perjury, to the Claims Administrator 15 by mail with a postmark no later than forty-five (45) days from the date of the mailed 16 request for information. Such additional information shall be considered part of the 17 original claim form and will relate back to the original filing date. The failure of a 18 claimant to timely respond to the request for information may result in the denial of the 19 claim. 20 2. Claimants who, for good cause shown, cannot submit the requested 21 information to complete the claim form, must provide the requested information, signed 22 under penalty of perjury, to the Claims Administrator by mail with a postmark no later 23 than sixty (60) days from the date of the mailed request for information.

Determining Eligibility. 6 27 1. The Claims Administrator shall make the determination as to 7 whether a 28 claim form is complete. If it is not complete, the Claims Administrator shall 8 request 29 additional information from the claimant, if it appears that such additional 9 information 1 would complete the claim formClaim Form. Such requests for information shall be in 10 writing and 2 shall specify the information necessary to complete the claim form. The 11 requests for 3 information will be sent via first class mail, printed in English and Spanish, 12 and inform 4 the claimant that a response must be returned no later than forty-five (45) 13 days from the 5 date the request for information was mailed. The claimant must provide 14 the requested 6 information, signed under penalty of perjury, to the Claims Administrator 15 by mail with a 7 postmark no later than forty-five (45) days from the date of the mailed 16 request for 8 information. Such additional information shall be considered part of the 17 original claim 9 form and will relate back to the original filing date. The failure of a 18 claimant to timely 10 respond to the request for information may result in the denial of the 19 claim. 20 2. Claimants who, for good cause shown, cannot submit the requested 21 information to complete the claim form, must provide the requested information, signed 22 under penalty of perjury, to the Claims Administrator by mail with a postmark no later 23 than sixty (60) days from the date of the mailed request for information.