Claims Review Procedure. Within 60 days after a Participant or Beneficiary receives notice from the Committee that his or her claim for benefits has been denied in any respect, he may file with the Committee a written notice of appeal setting forth his or her reasons for disputing the Committee’s determination. In connection with his or her appeal the Participant or Beneficiary or his or her representative may inspect or purchase copies of pertinent documents and records to the extent not inconsistent with other Participants’ and Beneficiaries’ rights of privacy. Within 60 days after receiving a notice of appeal from a prior determination (or within 120 days, if special circumstances require an extension of time and written notice of the extension is given to the Participant or Beneficiary and his or her representative within 60 days after receiving the notice of appeal), the Committee shall furnish to the Participant or Beneficiary and his or her representative, if any, a written statement of the Committee’s final decision with respect to his or her claim, including the reasons for such decision and the particular Plan provisions upon which it is based.
Claims Review Procedure. Within 60 days after a ParticipantClaim Review. Any Participant, Beneficiary or Beneficiary receives notice fromother claimant who does not agree with the decision rendered on the application may request that the Committee that his or her claimreview the decision. Each request for benefits has been deniedreview must be made in any respect, he may filea writing addressed to and filed with the Committee a written notice of appeal setting forth his or her reasons for disputing the Committee’s determination. In connection with his or her appeal the Participant or Beneficiary or his or her representative may inspect or purchase copies of pertinent documents and records to the extent not inconsistent with other Participants’ and Beneficiaries’ rights of privacy. Within 60within sixty (60) days after receiving a notice of appeal from a prior determination (orthe claimant receives the decision, or if the application has neither been approved nor denied within 120 days, if special circumstances require an extension of time and written notice of the extension is given to90-day period specified in [subsection (b)], then the Participant or Beneficiary and his or her representativerequest must be made within 60 days after receivingexpiration of the notice of appeal),90-day period. Concurrently with filing the request for review the claimant may submit in writing to the Committee shall furnish to the Participant or Beneficiary and his or her representative, if any, a written statement of the Committee’issues raised by his appeal and supporting arguments and comments. Where the Committee believes that the issues raised by the claimant’s finalappeal may be more efficiently or fairly processed by taking testimony of the claimant or others, it will set the matter for oral hearing and give the claimant reasonable notice of the time and place. The Committee will proceed promptly to resolve all issues raised by the claimant’s appeal and will render a written decision with respect to his or her claim, includingon the reasonsmerits within 60 days following the claimant’s request for such decisionreview. Any determination by the Committee after completion of the review process set forth herein shall be binding upon the Company and the particular Plan provisions upon which it is based.claimant.
Claims Review Procedure. Within 60If a claim of a Participant is wholly or partially denied, the Participant or his duly authorized representative may appeal the denial of the claim to the Committee. Such appeal must be made at any time within 30 days after athe Participant or Beneficiary receives written notice from the Committee that his or her claim for benefits has been denied in any respect, he may file withCompany of the Committee a written noticedenial of appeal setting forth his or her reasons for disputing the Committee’s determination.claim. In connection with his or her appealtherewith, the Participant or Beneficiary or his or herduly authorized representative may inspect or purchase copies of pertinent documents and records to the extent not inconsistent with other Participants’ and Beneficiaries’ rights of privacy. Within 60 days after receivingrequest a notice of appeal from a prior determination (or within 120 days, if special circumstances require an extension of time and written noticereview of the extension is given to the Participant or Beneficiarydenied claim, may review pertinent documents, and his or her representative within 60 days after receiving the noticemay submit issues and comments in writing. Upon receipt of appeal),an appeal, the Committee shall furnish to the Participant or Beneficiary and his or her representative, if any,make a written statement of the Committee’s final decision with respect to his or her claim,the appeal and, not later than 60 days after receipt of such request for review, shall furnish the Participant with the decision on review in writing, including the specific reasons for suchthe decision andwritten in a manner calculated to be understood by the particularParticipant, as well as specific references to the pertinent provisions of the Plan provisions upon which itthe decision is based.
Claims Review Procedure. Within 60 days afterProcedure: If an application filed by a Participant or Beneficiary receives notice fromunder Section 2.15 above shall result in a denial by the Committee that hisof the benefit applied for, either in whole or her claim for benefits has been denied in any respect, he may filepart, such applicant shall have the right, to be exercised by written request filed with the Committee a writtenwithin sixty (60) days after receipt of notice of appeal setting forththe denial of his or her reasonsapplication or, if no such notice has been given, within sixty (60) days after the application is deemed denied under Section 2.15, for disputing the Committee’s determination. In connection withreview of his or her appealapplication and of his entitlement to the Participant or Beneficiarybenefit for which he applied. Such request for review may contain such additional information and comments as the applicant may wish to present. Within sixty (60) days after receipt of any such request for review, the Committee shall reconsider the application in light of such additional information and comments as the applicant may have presented, and if the applicant shall have so requested, shall afford the applicant a hearing before the Committee. The Committee shall also permit the applicant or his or herdesignated representative may inspect or purchaseto review pertinent documents in its possession, including copies of pertinent documentsthe Plan document and recordsinformation provided by the Employer relating to the applicant's entitlement to such benefit. The Committee shall make a final determination with respect to the applicant's application for review as soon as practicable, and in any event not later am sixty (60) days after receipt of the aforesaid request for review, except that under special circumstances, such as the necessity for holding a hearing, such sixty-day period may be extended to the extent not inconsistent with other Participants’ and Beneficiaries’ rightsnecessary, but in no event beyond the expiration of privacy. Within 60one hundred twenty (120) days after receiving a noticereceipt by the Committee of appeal from a prior determination (or within 120 days, if special circumstances requiresuch request. If such an extension of time andfor review is required because of special circumstances, written notice of the extension is givenshall be furnished to the Participant or Beneficiary and his or her representative within 60 days after receivingapplicant before the noticecommencement of appeal),the extension. Notice of such final determination of the Committee shall furnishbe furnished to the Participant or Beneficiaryapplicant in writing, in a manner calculated to be understood by him, and his or her representative, if any, a written statementshall set forth the specific reasons for the decision and specific references to the pertinent provisions of the Committee’s finalPlan on which the decision with respect to his or her claim, includingis based. If the reasons for such decision andon review is not furnished within the particular Plan provisions upon which it is based.time period set forth above, the claim shall be deemed denied on review.
Claims Review Procedure. Within 60If the claim is denied and a review is desired, the Participant (or beneficiary) shall notify the Committee in writing within sixty (60) days after a Participant or Beneficiary receives notice fromreceipt of the Committee that his or her claim for benefits has been denied in any respect, he may file with the Committee a written notice of appeal setting forth his or her reasons for disputing the Committee’s determination.denial. In connection with his or her appealrequesting a review, the Participant or Beneficiary or his or her representativebeneficiary may inspect or purchase copiesrequest a review of pertinent documents and recordswith regard to the extent not inconsistent with other Participants’benefits created under this Plan, may submit any written issues and Beneficiaries’ rights of privacy. Within 60 days after receiving a notice of appeal from a prior determination (or within 120 days, if special circumstances requirecomments, may request an extension of time for such written submission of issues and written noticecomments, and may request that a hearing be held, but the decision to hold a hearing shall be within the sole discretion of the extension is given to the Participant or Beneficiary and his or her representative within 60 days after receiving the notice of appeal), the Committee shall furnish to the Participant or Beneficiary and his or her representative, if any, a written statement of the Committee’s final decision with respect to his or her claim, including the reasons for such decision and the particular Plan provisions upon which it is based.Committee.
Claims Review Procedure. Within 60 days afterThe claimant may request a Participant or Beneficiary receives notice fromreview of a denied claim by writing the Committee that his or her claim for benefits has been denied in any respect, he may file with the Committee a written notice of appeal setting forth his or her reasons for disputing the Committee’s determination. In connection with his or her appeal the Participant or Beneficiary or his or her representative may inspect or purchase copies of pertinent documents and records to the extent not inconsistent with other Participants’ and Beneficiaries’ rights of privacy. Within 60 days after receiving a notice of appeal from a prior determination (or within 120 days, if special circumstances require an extension of time and written noticecare of the extension is given to the Participant or Beneficiary and his or her representativePlan Administrator. The appeal must, however, be made within 60 days after receiving the claimant's receipt of notice of appeal),the denial of the claim. Pertinent documents may be reviewed in preparing an appeal, and issues and comments may be submitted in writing. An appeal shall be given a complete review by the Committee, and a written decision, including reasons, shall be provided within 60 days. If there are special circumstances requiring an extensive review, the Committee shall furnish tonotify the Participant or Beneficiary and his or her representative, if any,claimant in a written statementnotice within the original 60 day period of its receipt of the Committee’sappeal and indicating that the decision will be delayed. A final decision with respect to his or her claim, includingon the reasons for such decision andappeal shall be made within 120 days of the particular Plan provisions upon which it is based.Committee's receipt of the appeal.
Claims Review Procedure. Within 60 days afterIf a Participantclaim is denied, in whole or Beneficiary receives notice from the Committee that his or her claim for benefits has been denied in any respect, he may file with the Committee a written notice of appeal setting forth his or her reasons for disputing the Committee’s determination. In connection with his or her appealpart, the Participant or Beneficiary or his or her representative may inspect or purchase copies of pertinent documents and records to the extent not inconsistent with other Participants’ and Beneficiaries’ rights of privacy. Within 60 days after receiving a notice of appeal from a prior determination (or within 120 days, if special circumstances require an extension of time and written noticewill be notified in writing of the extensionspecific reason(s) for the denial, the exact Plan provision(s) on which the decision was based, what additional material or information is given to the Participant or Beneficiary and his or her representative within 60 days after receiving the notice of appeal), the Committee shall furnish to the Participant or Beneficiary and his or her representative, if any, a written statement of the Committee’s final decision with respectrelevant to his or her claim, includingcase, and what procedure the reasons for suchParticipant should follow to get the claim reviewed again. The Participant then has 60 days to appeal the decision andto the particular Plan provisions upon which it is based.Committee.
Claims Review Procedure.Notification by Committee. Within 60 days after a Participant or Beneficiary receives notice from the Committee that his or her claim for benefits has been denied in any respect, he may file with the Committee a written notice of appeal setting forth his or her reasons for disputing the Committee’s determination. In connection with his or her appeal the Participant or Beneficiary or his or her representative may inspect or purchase copies of pertinent documents and records to the extent not inconsistent with other Participants’ and Beneficiaries’ rights of privacy. Within 6090 days after receiving a notice of appeal from a prior determinationclaim for benefits (or within 120180 days, if special circumstances require an extension of time and written notice of the extension is given to the Participant or Beneficiary and his or her representative within 6090 days after receiving the notice of appeal)claim for benefits), the Committee shall furnishnotify the Participant or Beneficiary whether the claim has been approved or denied. If the Committee denies a claim in any respect, the Committee shall set forth in a written notice to the Participant or Beneficiary and his or her representative, if any, a written statement of the Committee’s final decision with respect to his or her claim, including the reasons for such decision and the particular Plan provisions upon which it is based.Beneficiary:
Claims Review Procedure. Within 60 days afterUpon request, a Participant or Beneficiary receives notice from the Committee that his or her claim for benefits has been denied in any respect, he may file with the Committee a written notice of appeal setting forth his or her reasons for disputing the Committee’s determination. In connection with his or her appeal the Participant or Beneficiary or his or her representative may inspectbeneficiary will be provided without charge, reasonable access to, and copies of, all non-confidential documents that are relevant to any denial of benefits. A claimant has 60 days from the day he or purchase copies of pertinent documentsshe receives the original denial to request a review. Such request must be made in writing and recordssent to the extent not inconsistent with other Participants’ and Beneficiaries’ rights of privacy. Within 60 days after receiving a notice of appeal from a prior determination (or within 120 days, if special circumstances require an extension of time and written notice of the extension is given to the Participant or Beneficiary and his or her representative within 60 days after receiving the notice of appeal), the Committee shall furnish to the Participant or Beneficiary and his or her representative, if any, a written statement of the Committee’s final decision with respect to his or her claim, includingCommittee. The request should state the reasons for such decisionwhy the claim should be reviewed and may also include evidence or documentation to support the particular Plan provisions upon which it is based.claimant’s position.
Claims Review Procedure. Within 60 days after a Participant or Beneficiary receives notice from the Committee that his or her claim14.6Appeal and Review. A claimant for benefits whose claim has been denied in any respect, hewhole or in part, or the duly authorized representative of such claimant, may file with the Committee awithin sixty (60) days after receipt of written notice of such denial request an appeal setting forth his or her reasons for disputing the Committee’sof such determination. In connection with his or her appeal the Participant or Beneficiary or his or her representativeThe claimant (or authorized representative) may inspect or purchase copies of pertinent documentssubmit written comments, documents, records and recordsother information relating to the extentclaim. The claimant (or authorized representative) shall be provided, upon request and free of charge, reasonable access to, and copies of, all documents, records and other information relevant to the claim (as determined pursuant to [Section 503] of ERISA). The review by the Committee will take into account all comments, documents, records and other information submitted by the claimant (or authorized representative) relating to the claim, without regard to whether such information was submitted or considered in the initial benefit determination. The Committee will then render its final decision in writing and will transmit such written decision to the claimant within a reasonable period of time, but not inconsistent with other Participants’ and Beneficiaries’ rights of privacy. Within 60later than sixty (60) days after receivingreceipt of such request for review unless # the time for such decision is postponed by agreement, or # the Committee # determines that special circumstances (such as the need to hold a hearing) require an extension (for no more than a single additional sixty (60) day period) of time for reviewing the claim, and # furnishes the claimant written notice of appeal from a prior determination (or within 120 days, ifsuch extension before the termination of the initial sixty (60) day period, such notice to indicate the special circumstances requirerequiring an extension of time and the date by which the Committee expects to render the determination on review. The Committee shall provide the claimant written notification of its determination on review. In the case of an adverse benefit determination, such notice ofshall set forth, in a manner calculated to be understood by the extension is givenclaimant, # the specific reason or reasons for the adverse determination, # references to the Participant or Beneficiaryspecific Plan provision on which the benefit determination is based, # a statement that the claimant is entitled to receive, upon request and his or her representative within 60 days after receiving the noticefree of appeal), the Committee shall furnish to the Participant or Beneficiarycharge, reasonable access to, and his or her representative, if any, a written statement of the Committee’s final decision with respect to his or her claim, including the reasons for such decision and the particular Plan provisions upon which it is based.
AllDrafts is a cloud-based editor designed specifically for contracts. With automatic formatting, a massive clause library, smart redaction, and insanely easy templates, it’s a welcome change from Word.
And AllDrafts generates clean Word and PDF files from any draft.