Filing Appeals Clause Samples

Filing Appeals. 7.1 Each German company shall, upon the completion of its processing of the claimant’s claim send to the claimant; 7.1.1 the determination regarding the claimant’s entitlement to the claimed insurance policy; 7.1.2 all documents relevant to the claim and to the company’s decision; 7.1.3 notice that an appeal against the determination is possible and on the time within which an appeal shall be filed; 7.1.4 an Appeal Form (Annex G) should the claimant want to appeal against the German company determination; and 7.1.5 a copy of these Guidelines. 7.2 A claimant wishing to file an appeal shall sign the Appeals Form and submit it by post to the Panel. Together with the form the claimant shall file the following: 7.2.1 a written statement of the grounds and reasons for making the appeal; and 7.2.2 any information or evidence supporting the appeal not already submitted to the claims process. 7.3 Any new information or evidence shall be forwarded to the German company and the GDV. In light of the new information or evidence the German company has the opportunity to make an offer to the claimant. 7.4 The appeal shall not be processed by the Panel, Panel Member or Arbiter before 30 working days have expired from the date the German company received the new evidence or information.
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Filing Appeals. You or your authorized representative, someone you have named to act on your behalf, may file an appeal. To appoint an authorized representative, you must sign an authorization form and mail or fax the signed form to the address or phone number listed above. This release provides us with the authorization for this person to appeal on your behalf and allows our release of information, if any, to them. Please call us for an Authorization for Release form. You can also obtain a copy of this form on our web site at ▇▇▇.▇▇▇▇.▇▇▇. You or your authorized representative may file an appeal by calling Customer Service or by writing to us at the address listed below. We must receive your appeal request as follows:  For a Level I appeal, within 180 calendar days of the date you were notified of the adverse benefit determination; and  For a Level II appeal, within 60 calendar days of the date you were notified of the Level I determination. If you are hospitalized or traveling, or for other reasonable cause beyond your control, we will extend this timeline up to 180 calendar days to allow you to obtain additional medical documentation, physician consultations or opinions. You may submit your written appeal request to: If you need help filing an appeal, or would like a copy of the appeals process, please contact the CHPW customer service team at 1‐800‐930‐0132, Monday through Friday from 8am to 5pm, or email ▇▇▇▇▇▇▇▇▇▇▇▇@▇▇▇▇.▇▇▇. If you are hearing or speech impaired, please call TTY 1‐866‐816‐2479 (toll free) or local 206‐613‐8875. You can also get a description of the appeals process by visiting our web page at ▇▇▇.▇▇▇▇.▇▇▇.
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Filing Appeals. (i) DVHA must allow beneficiaries to file appeals. DVHA must also allow providers, or authorized representatives, acting on behalf of the beneficiary and with the beneficiary's written consent, to request an appeal. DVHA must consider the beneficiary, his/her representative, or the legal representative of a deceased beneficiary’s estate as parties to an appeal. (ii) Appeals may be filed within 60 calendar days from the date on the adverse benefit determination notice. (iii) Beneficiaries, or their providers or authorized representatives, may file appeals orally or in writing for any DVHA adverse benefit determination. Oral inquiries to an internal appeal of an adverse benefit determination must be treated as appeals to establish the earliest possible filing date. (iv) DVHA must provide each beneficiary seeking an appeal a reasonable opportunity, in person and in writing, to present evidence and testimony and make legal and factual arguments. (v) DVHA must provide each beneficiary and his or her representative with the beneficiary's case file (including medical records, other documents and records, and any new or additional evidence considered, relied upon, or generated by DVHA (or at the direction of DVHA)) in connection with the appeal of an adverse benefit determination. DVHA must provide the case file free of charge and sufficiently in advance of the resolution timeframe for standard and expedited appeal resolutions.
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Filing Appeals. DocuSign Envelope ID: F73EF454-508D-44AC-ABD8-2A528194331A (i) DVHA must allow beneficiaries to file appeals. DVHA must also allow providers, or authorized representatives, acting on behalf of the beneficiary and with the beneficiary's written consent, to request an appeal. ▇▇▇▇ must consider the beneficiary, his/her representative, or the legal representative of a deceased beneficiary’s estate as parties to an appeal. (ii) Appeals may be filed within 60 calendar days from the date on the adverse benefit determination notice. (iii) Beneficiaries, or their providers or authorized representatives, may file appeals orally or in writing for any DVHA adverse benefit determination. Oral inquiries to an internal appeal of an adverse benefit determination must be treated as appeals to establish the earliest possible filing date. (iv) DVHA must provide each beneficiary seeking an appeal a reasonable opportunity, in person and in writing, to present evidence and testimony and make legal and factual arguments. (v) DVHA must provide each beneficiary and his or her representative with the beneficiary's case file (including medical records, other documents and records, and any new or additional evidence considered, relied upon, or generated by DVHA (or at the direction of DVHA)) in connection with the appeal of an adverse benefit determination. DVHA must provide the case file free of charge and sufficiently in advance of the resolution timeframe for standard and expedited appeal resolutions.
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Related to Filing Appeals

  • Legal Appeals a. Nothing contained in these provisions is intended to limit or impair the rights of any vendor or Contractor to seek and pursue remedies of law through the judicial process. Appendix C, Contract Modification Procedure, attached hereto, is hereby expressly made a part of this Contract as fully as if set forth at length herein. Appendix D, Pricing Schedules, attached hereto, is hereby expressly made a part of this Contract as fully as if set forth at length herein. The Parties expressly agree that these prices are established as “maximum Not-To-Exceed prices”. The Contractor acknowledges that any mini-bid under this Centralized Contract which includes pricing in excess of the “maximum Not-To-Exceed price” shall be rejected by the Authorized User. Amendments to Appendix D, Pricing Schedules, shall be processed in accordance with Appendix C, Contract Modification Procedure, section 4.8, OGS Centralized Contract Modifications and section 4.23 Price Adjustments for OGS Centralized Contracts. Appendix E, Report of Contract Purchases, attached hereto, is hereby expressly made a part of this Contract as fully as if set forth at length herein. OGS reserves the right to make unilateral changes to this Report of Contract Purchases document. Appendix F, Project Based Information Technology Consulting Services Processes and Forms, attached hereto, is hereby expressly made a part of this Contract as fully as if set forth at length herein. OGS reserves the right to change the processes and forms set forth Appendix F in non-material and substantive ways without seeking a contract amendment. Appendix F is comprised of the following attachments: a. Attachment 1- Mini-Bid Template b. Attachment 2- How to Use This Contract c. Attachment 3- Enhancement Request Template d. Attachment 4- No Cost Change Request Template e. Attachment 5- Mini-Bid Participation Interest Template Appendix G, Contractor and OGS Information, attached hereto, is hereby expressly made a part of this Contract as fully as if set forth at length herein. The Parties agree that the elements identified in 4.7.1 below, OGS Designated Contact information, and information regarding Procurement Card acceptance as presented in Appendix G can be updated without the Parties engaging in a formal contract amendment. All other changes must be handled through the Contract Modification Process or a formal contract amendment.

  • SCHOOL ACT APPEALS Where a pupil and/or parent/guardian files an appeal under the School Act (Section 11) and Board by-law of a decision of an employee covered by this Agreement, or in connection with or affecting such an employee,

  • How to File an Appeal of a Prescription Drug Denial For denials of a prescription drug claim based on our determination that the service was not medically necessary or appropriate, or that the service was experimental or investigational, you may request an appeal without first submitting a request for reconsideration. You or your physician may file a written or verbal prescription drug appeal with our pharmacy benefits manager (PBM). The prescription drug appeal must be submitted to us within one hundred and eighty (180) calendar days of the initial determination letter. You will receive written notification of our determination within thirty (30) calendar days from the receipt of your appeal. Your appeal may require immediate action if a delay in treatment could seriously jeopardize your health or your ability to regain maximum function, or would cause you severe pain. To request an expedited appeal of a denial related to services that have not yet been rendered (a preauthorization review) or for on-going services (a concurrent review), you or your healthcare provider should call: • our Grievance and Appeals Unit; or • our pharmacy benefits manager for a prescription drug appeal. Please see Section 9 for contact information. You will be notified of our decision no later than seventy-two (72) hours after our receipt of the request. You may not request an expedited review of covered healthcare services already received.

  • Appeals a. Should the filer be dissatisfied with the Formal Dispute determination, a written appeal may be filed with the Chief Procurement Officer, by mail or email, using the following contact information: ▇▇▇▇ ▇▇▇▇▇, ▇▇▇▇▇▇▇ ▇▇▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇▇ ▇▇▇▇▇ ▇▇▇▇▇▇, ▇▇ ▇▇▇▇▇ Email: ▇▇▇▇▇▇▇▇.▇▇▇▇▇▇▇▇@▇▇▇.▇▇.▇▇▇ Subject line: Appeal – Attn: Chief Procurement Officer b. Written notice of appeal of a determination must be received at the above address no more than ten (10) business days after the date the decision is received by the filer. The decision of the Director of Procurement Services shall be a final and conclusive agency determination unless appealed to the Chief Procurement Officer within such time period. c. The Chief Procurement Officer shall hear and make a final determination on all appeals or may designate a person or persons to act on his/her behalf. The final determination on the appeal shall be issued within twenty (20) business days of receipt of the appeal. d. An appeal of the decision of the Director of Procurement Services shall not include new facts and information unless requested in writing by the Chief Procurement Officer. e. The decision of the Chief Procurement Officer shall be a final and conclusive agency determination.

  • Filing of Patent Applications Each Party will make timely decisions regarding the filing of Patent Applications on the CRADA Subject Inventions made solely by its employee(s), and will notify the other Party in advance of filing. Collaborator will have the first opportunity to file a Patent Application on joint CRADA Subject Inventions and will notify PHS of its decision within sixty (60) days of an Invention being reported or at least thirty (30) days before any patent filing deadline, whichever occurs sooner. If Collaborator fails to notify PHS of its decision within that time period or notifies PHS of its decision not to file a Patent Application, then PHS has the right to file a Patent Application on the joint CRADA Subject Invention. Neither Party will be obligated to file a Patent Application. Collaborator will place the following statement in any Patent Application it files on a CRADA Subject Invention: “This invention was created in the performance of a Cooperative Research and Development Agreement with the [INSERT into Agency’s model as appropriate: National Institutes of Health, Food and Drug Administration, Centers for Disease Control and Prevention], an Agency of the Department of Health and Human Services. The Government of the United States has certain rights in this invention.” If either Party files a Patent Application on a joint CRADA Subject Invention, then the filing Party will include a statement within the Patent Application that clearly identifies the Parties and states that the joint CRADA Subject Invention was made under this CRADA.