Section E Claims Process Clause Samples

Section E Claims Process. 7.1 Claim Reporting On the occurrence or discovery of any Injury that may give rise to a Claim under this Policy, We shall be given the intimation within 10 days on our toll free Address: Claims Manager Kotak Mahindra General Insurance Company Ltd. 8th Floor, Zone IV, Kotak Infiniti, Bldg. 21,Infinity IT Park, Off WEH, Gen. AK ▇▇▇▇▇▇ ▇▇▇▇, Dindoshi, Malad (E), Mumbai – 400097. India. 7.2 Claims administration The fulfilment of the terms and conditions of this Policy (including payment of premium by the due dates mentioned in the Policy Schedule/ Certificate of a) On the occurrence or discovery of any Injury that may give rise to a Claim under this Policy, the Claims Procedure set out below shall be followed; b) The directions, advice and guidance of the treating Medical Practitioner shall be strictly followed. We shall not be obliged to make any payments that are brought about or contributed to as a consequence of intentional/deliberate failure to follow such directions, advice or guidance; c) If requested by Us and at Our cost, We may conduct Medical examination by any Medical Practitioner for this purpose when and so often as We may reasonably require. Such medical examination will be carried out only in case of reimbursement claims with prior consent of the Insured Person and We/Our representatives must be permitted to inspect the medical and Hospitalisation records pertaining to the Insured Person’s treatment and to investigate the facts surrounding the Claim; d) We/Our representatives must be given all reasonable co-operation in investigating the Claim in order to assess Our liability and quantum in respect of such Claim;
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Section E Claims Process 
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Related to Section E Claims Process

  • Claims Process We have appointed the senior trustee as the authorized representative to take action on behalf of holders of the notes under the guarantee. The authorized representative has agreed to make a demand of the FDIC upon our failure to pay interest or principal on the notes when due. As provided in the FDIC’s regulations, a holder will also have the option to elect not to be represented by the authorized representative. Upon our failure to pay interest or principal, the authorized representative and a holder that has elected not to be so represented must follow the FDIC’s required procedures for making a demand under the guarantee. In addition to the procedures described below, the authorized representative will be required when making a demand, to the extent not previously provided in the master agreement, to provide the FDIC with information regarding its authority, including: its financial and organizational capacity to act as representative, its exclusive authority to act on behalf of each noteholder and its fiduciary responsibility to the noteholders when acting as such, as established by the senior indenture, and its authority to make the assignment of each noteholder’s right, title, and interest in the notes to the FDIC. Any demand under the guarantee must be accompanied by a proof of claim, satisfactory in form and content to the FDIC, which includes evidence of the occurrence of a payment default and the claimant’s ownership of the applicable notes. The claimant must provide to the FDIC an assignment, satisfactory in form and content to the FDIC, of the noteholder’s right, title and interest in the notes to the FDIC and the transfer to the FDIC of any claim in any insolvency proceeding against us. The assignment must also grant to the FDIC the right to receive any and all distributions on the note from the proceeds of any bankruptcy. If a holder receives a payment on a note from a bankruptcy, any obligation of the FDIC under the guarantee would be reduced proportionally. Demands must be made by the authorized representative or by a holder that elects not to be represented by the authorized representative within 60 days of the occurrence of the payment default. Upon payment by the FDIC of any amount under the guarantee, the FDIC will be subrogated to the rights of the recipient noteholder against us, including in respect of any insolvency proceeding, to the extent of such payment.

  • Claims Procedure An Executive or Beneficiary (“claimant”) who has not received benefits under this Agreement that he or she believes should be distributed shall make a claim for such benefits as follows:

  • Appeals Process (a) The incumbent(s), the designated manager, ▇▇▇▇▇▇▇ or the Employer, can appeal Joint Job Evaluation Committee decisions for existing positions. (b) Appeals may be filed based on the following criteria: (i) The evaluation results are not consistent with the benchmarks, or (ii) Extenuating circumstances, or (iii) A violation of Article 14 of the Collective Agreement. (c) If an incumbent and/or designated manager decides to appeal a Joint Job Evaluation Committee’s decision, their intent to appeal must be submitted by email or written notification to the Compensation Office within ten (10) working days of receipt of the Evaluation Report. (d) If YusApuY or the Employer appeals a Joint Job Evaluation Committee’s decision, it must be submitted by email or written notification to the Employer or YusApuY within ten (10) working days of receipt of the Evaluation Report. (e) Incumbent(s), the designated manager, YusApuY and the Employer shall be notified within five (5) working days of any submitted appeal of a Joint Job Evaluation Committee’s decision. (f) YusApuY and the Compensation Office shall each prepare a written rationale within six (6) months of the appeal being initiated. The rationale shall be based only on the Job Evaluation Questionnaire and related information submitted to the Joint Job Evaluation Committee and shall identify criteria for appeal, the evaluation factor level(s) the Party(s) is appealing/responding to, and the recommended evaluation factor level(s) with supporting justification. (g) A Joint Appeals Committee shall consider an appeal of an evaluation decision made by a Joint Job Evaluation Committee based on the following process: (i) The Joint Appeals Committee shall have access to: all information provided to the Joint Job Evaluation Committee(s); all documentation prepared by the Joint Job Evaluation Committee and written appeal rationale documentation. (ii) Based on all information provided, the Joint Appeals Committee shall determine if there are sufficient grounds to assign a different level to the appealed factor(s), or confirm the factor level(s) assigned by the Joint Job Evaluation Committee. If the Joint Appeals Committee determines that clarification of submitted information is required, the Committee shall interview the incumbent and the designated manager. (iii) The Joint Appeals Committee shall have the right to override any evaluated factor established by the Joint Job Evaluation Committee. (iv) The Joint Appeals Committee shall make a decision within three (3) months of the submission of the written rationales per Article 14.08(f). (v) Joint Appeals Committee decisions shall be made by consensus and shall be final and binding on both Parties. When consensus is not reached, then the appeal and all submitted documentation shall be directed to a Labour/Management committee for binding resolution.

  • Claims Processing BCBSM will process Provider's Clean Claims submitted in accordance with this Agreement in a timely fashion.

  • Claims Procedures Each Party entitled to be indemnified by the other Party (an “Indemnified Party”) pursuant to Section 8.1 or 8.2 hereof shall give notice to the other Party (an “Indemnifying Party”) promptly after such Indemnified Party has actual knowledge of any threatened or asserted claim as to which indemnity may be sought, and shall permit the Indemnifying Party to assume the defense of any such claim or any litigation resulting therefrom; provided: (a) That counsel for the Indemnifying Party, who shall conduct the defense of such claim or any litigation resulting therefrom, shall be approved by the Indemnified Party (whose approval shall not unreasonably be withheld) and the Indemnified Party may participate in such defense at such party’s expense (unless (i) the employment of counsel by such Indemnified Party has been authorized by the Indemnifying Party; or (ii) the Indemnified Party shall have reasonably concluded that there may be a conflict of interest between the Indemnifying Party and the Indemnified Party in the defense of such action, in each of which cases the Indemnifying Party shall pay the reasonable fees and expenses of one law firm serving as counsel for the Indemnified Party, which law firm shall be subject to approval, not to be unreasonably withheld, by the Indemnifying Party); and (b) The failure of any Indemnified Party to give notice as provided herein shall not relieve the Indemnifying Party of its obligations under this Agreement to the extent that the failure to give notice did not result in harm to the Indemnifying Party. (c) No Indemnifying Party, in the defense of any such claim or litigation, shall, except with the approval of each Indemnified Party which approval shall not be unreasonably withheld, consent to entry of any judgment or enter into any settlement which (i) would result in injunctive or other relief being imposed against the Indemnified Party; or (ii) does not include as an unconditional term thereof the giving by the claimant or plaintiff to such Indemnified Party of a release from all liability in respect to such claim or litigation. (d) Each Indemnified Party shall furnish such information regarding itself or the claim in question as an Indemnifying Party may reasonably request in writing and shall be reasonably required in connection with the defense of such claim and litigation resulting therefrom.