Special Timing Rules for Disability Claims Sample Clauses

The "Special Timing Rules for Disability Claims" clause establishes specific deadlines and procedures for handling disability-related insurance or benefit claims. It typically outlines the timeframes within which a claimant must submit required documentation and the period in which the insurer or plan administrator must respond or make a determination. For example, it may provide extended deadlines for claimants to submit medical evidence or require expedited review processes. The core function of this clause is to ensure that individuals with disabilities receive timely and fair consideration of their claims, addressing potential delays and providing clear expectations for both parties.
Special Timing Rules for Disability Claims. In the event a claim above is a claim for disability benefits, then the applicable time periods for notifying claimants regarding benefits determinations shall be reduced as required by 29 CFR 2560.503-1 (I.e., (a) the ninety (90) day response time with the possibility of a ninety (90) day extension in Section 8.2B shall be shortened to a forty-five (45) day response time with the possibility of a thirty (30) day extension, and (b) the sixty (60) day response time with the possibility of a sixty (60) day extension in shall be shortened to a forty-five (45) day response time with the possibility of a forty-five (45) day extension). In addition, in the event of a disability claim, the Bank shall identify any medical or vocational expert whose advice was obtained by the Plan in connection with the initial benefit determination, without regard to whether the advice was relied upon. If the review is from an adverse benefit determination that was based in whole or in part on a medical judgment, the Bank shall consult with a health care professional that has appropriate training and experience in the field of medicine involved in the medical judgment and who is neither the individual who was consulted in connection with the adverse benefit determination that is under review nor the subordinate of such individual. Any review of the denial of a claim made on account of disability shall be conducted by a person or persons who neither had any part in the initial benefit determination nor are subordinates of the persons who did.
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Related to Special Timing Rules for Disability Claims

  • Long Term Disability Benefit The Long Term Disability insurance provides income security should you become totally disabled prior to age 65 due to a sickness or injury which totally disables you over a long period of time. The Plan provides you with coverage on and off the job.

  • By Disability If Executive becomes eligible for the Company’s long term disability benefits or if, in the sole opinion of the Company, Executive is unable to carry out the responsibilities and functions of the position held by Executive by reason of any physical or mental impairment for more than ninety consecutive days or more than one hundred and twenty days in any twelve-month period, then, to the extent permitted by law, the Company may terminate Executive’s employment. The Company shall pay to Executive all compensation to which Executive is entitled up through the date of termination, and thereafter all obligations of the Company under this Agreement shall cease. Nothing in this Section shall affect Executive’s rights under any disability plan in which Executive is a participant.

  • Long Term Disability Benefits The District shall provide each eligible employee with long-term disability insurance as follows: 18.5.1 The insurance shall provide a disability payment equal to 66-2/3% of the employee's "basic monthly earnings" on the date they were disabled to a maximum payment of $6,000 per month. "Basic monthly earnings" means 1/12th of the employee's annual contract salary. 18.5.2 The disability payment under the long-term disability shall begin after all accumulated sick leave and extended sick leave under Article 10 has been used. 18.5.3 For employees with five (5) years or more of STRS service and two (2) or more eligible children on the date of disability, disability payment shall be paid for one year from the date of disability for both accident and illness provided that the employee is sixty-nine (69) years of age or younger on the date of disability. If the period of disability extends beyond one year, the employee shall receive disability allowance payment from STRS. 18.5.4 For all employees not included under Section 18.5.3, the disability payments shall be payable for ten (10) years from the date of disability for both accident and illness provided that the employee is fifty-five (55) years of age or younger on the date of disability. If the employee is older than fifty-five (55) years on the date of disability, the maximum disability payment period shall be the same as that provided in the maximum disability payment schedule set forth in the District's income protection insurance plan. 18.5.5 An employee who has separated from the District due to medical reasons and is receiving long-term disability payments under Section 18.5 shall be eligible to receive health benefits under 18.2.1 for a period of three (3) years provided that the employee has been employed by the District for at least five (5) years prior to the employee’s separation date.

  • Disability Benefits Technology Errors and Omissions Not less than $1,000,000 each claim Not less than $2,000,000 in aggregate At the time of the first transaction with an Authorized User and updated in accordance with Contract Crime Insurance Not less than $50,000 Commercial General Liability Not less than $5,000,000 each occurrence Updated in accordance with Contract General Aggregate $2,000,000 Products – Completed Operations Aggregate $2,000,000 Personal and Advertising Injury $1,000,000 Business Automobile Liability Insurance Not less than $5,000,000 each occurrence

  • Order of Benefit Determination Rules When a Member is covered by two or more plans, the rules for determining the order of benefit payments are as follows: