Common use of Manner and Content of Denial of Initial Claims Clause in Contracts

Manner and Content of Denial of Initial Claims. If the Bank denies a claim, it must provide to the Claimant, in writing or by electronic communication: (A) The specific reasons for the denial; (B) A reference to the Agreement provision or insurance contract provision upon which the denial is based; (C) A description of any additional information or material that the Claimant must provide in order to perfect the claim; (D) An explanation of why such additional material or information is necessary; (E) Notice that the Claimant has a right to request a review of the claim denial and information on the steps to be taken if the Claimant wishes to request a review of the claim denial; and (F) A statement of the Executive’s right to bring a civil action under Section 502(a) of the Employee Retirement Income Security Act of 1974, as amended (“ERISA”) following a denial on review of the initial denial. In addition, in the case of a denial of Disability benefits on the basis of the Bank’s independent determination of the Executive’s Disability status, the Bank will provide a copy of any rule, guideline, protocol, or other similar criterion relied upon in making the adverse determination (or a statement that the same will be provided upon request by the Claimant and without charge).

Appears in 3 contracts

Sources: Supplemental Executive Retirement Agreement (Fairfield County Bank Corp.), Supplemental Executive Retirement Agreement (Fairfield County Bank Corp.), Supplemental Executive Retirement Agreement (Fairfield County Bank Corp.)

Manner and Content of Denial of Initial Claims. If the Bank Company denies a claim, it must provide to the Claimant, in writing or by electronic communication: (A) The specific reasons for the denial; (B) A reference to the Agreement Plan provision or insurance contract provision upon which the denial is based; (C) A description of any additional information or material that the Claimant must provide in order to perfect the claim; (D) An explanation of why such additional material or information is necessary; (E) Notice that the Claimant has a right to request a review of the claim denial and information on the steps to be taken if the Claimant wishes to request a review of the claim denial; and (F) A statement of the ExecutiveParticipant’s right to bring a civil action under Section section 502(a) of the Employee Retirement Income Security Act of 1974, as amended (“ERISA”) following a denial on review of the initial denial. In addition, in the case of a denial of Disability benefits on the basis of the BankCompany’s independent determination of the ExecutiveParticipant’s Disability status, the Bank Company will provide a copy of any rule, guideline, protocol, or other similar criterion relied upon in making the adverse determination (or a statement that the same will be provided upon request by the Claimant and without charge).

Appears in 1 contract

Sources: Executive Death Benefit Plan (Fairfield County Bank Corp.)

Manner and Content of Denial of Initial Claims. If the Bank Board denies a claim, it must provide to the Claimant, in writing or by electronic communication: (A) The specific reasons for the denial; (B) A reference to the Agreement provision or insurance contract provision upon which the denial is based; (C) A description of any additional information or material that the Claimant must provide in order to perfect the claim; (D) An explanation of why such additional material or information is necessary; (E) Notice that the Claimant has a right to request a review of the claim denial and information on the steps to be taken if the Claimant wishes to request a review of the claim denial; and (F) A statement of the Executive’s right to bring a civil action under Section section 502(a) of the Employee Retirement Income Security Act of 1974, as amended (“ERISA”) following a denial on review of the initial denial. In addition, in the case of a denial of Disability benefits on the basis of the BankBoard’s independent determination of the ExecutiveDirector’s Disability status, the Bank Board will provide a copy of any rule, guideline, protocol, or other similar criterion relied upon in making the adverse determination (or a statement that the same will be provided upon request by the Claimant and without charge).

Appears in 1 contract

Sources: Director Retirement Agreement (Fairfield County Bank Corp.)

Manner and Content of Denial of Initial Claims. If the Bank denies a claim, it must provide to the Claimant, in writing or by electronic communication: (A) The specific reasons for the denial; (B) A reference to the Agreement provision or insurance contract provision upon which the denial is based; (C) A description of any additional information or material that the Claimant must provide in order to perfect the claim; (D) An explanation of why such additional material or information is necessary; (E) Notice that the Claimant has a right to request a review of the claim denial and information on the steps to be taken if the Claimant wishes to request a review of the claim denial; and (F) A statement of the Executive’s right to bring a civil action under Section 502(a) of the Employee Retirement Income Security Act of 1974, as amended (“ERISAERlSA”) following a denial on review of the initial denial. In addition, in the case of a denial of Disability benefits on the basis of the Bank’s independent determination of the Executive’s Disability status, the Bank will provide a copy of any rule, guideline, protocol, or other similar criterion relied upon in making the adverse determination (or a statement that the same will be provided upon request by the Claimant and without charge).

Appears in 1 contract

Sources: Supplemental Executive Retirement Agreement (Fairfield County Bank Corp.)

Manner and Content of Denial of Initial Claims. If the Bank Company denies a claim, it must provide to the Claimant, in writing or by electronic communication: (A) The specific reasons for the denial; (B) A reference to the Agreement provision or insurance contract provision upon which the denial is based; (C) A description of any additional information or material that the Claimant must provide in order to perfect the claim; (D) An explanation of why such additional material or information is necessary; (E) Notice that the Claimant has a right to request a review of the claim denial and information on the steps to be taken if the Claimant wishes to request a review of the claim denial; and (F) A statement of the ExecutiveDirector’s right to bring a civil action under Section section 502(a) of the Employee Retirement Income Security Act of 1974, as amended (“ERISA”) following a denial on review of the initial denial. In addition, in the case of a denial of Disability benefits on the basis of the BankCompany’s independent determination of the ExecutiveDirector’s Disability status, the Bank Company will provide a copy of any rule, guideline, protocol, or other similar criterion relied upon in making the adverse determination (or a statement that the same will be provided upon request by the Claimant and without charge).

Appears in 1 contract

Sources: Director Deferred Fee Agreement (Fairfield County Bank Corp.)