Example ContractsClausesdecision upon reviewVariants
Remove:

12.2Review of Claim Denial. If a claim is denied, in whole or in part, the claimant shall have the right to # request that the Officer Committee review the denial, # review pertinent documents, and # submit issues and comments in writing, provided that the claimant files a written request for review with the Officer Committee within 60 days after the date on which the claimant received written notice from the Officer Committee of the denial. Within 60 days after the Officer Committee receives a properly filed request for review, the Officer Committee shall conduct such review and advise the claimant in writing of its decision on review, unless special circumstances require an extension of time for conducting the review. If an extension of time for conducting the review is required, the Officer Committee shall provide the claimant with written notice of the extension before the expiration of the initial 60-day period, specifying the circumstances requiring an extension and the date by which such review shall be completed (which date shall not be later than 120 days after the date on which the Officer Committee received the request for review). The Officer Committee shall inform the claimant of its decision on review in a written notice, setting forth the specific reason(s) for the decision and reference to Plan provisions upon which the decision is based. A decision on review shall be final and binding on all persons for all purposes.

12.2Review

A claimant is entitled to request a review of Claim Denial. Ifany denial of his or her claim under [Section 8.4(a)]. The request for review must be submitted to the Committee in writing within 60 days of mailing by the Committee of notice of the denial. Absent a request for review within the 60 day period, the claim is denied, in wholewill be deemed conclusively denied. The claimant or in part, the claimanthis or her representative shall have the rightbe entitled to # request that the Officer Committee review the denial, # reviewall pertinent documents, and #to submit issues and comments orally and in writing, provided thatwriting to the Committee. The review shall be conducted by the Committee, which shall afford the claimant files a written request for review with the Officer Committeehearing and which shall render a decision in writing within 60 days after the date on which the claimant received written notice from the Officer Committee of the denial. Within 60 days after the Officer Committee receives a properly filed request for a review, provided that, if the Officer Committee shall conductdetermines prior to the end of such 60 day review and advise the claimant in writing of its decision on review, unlessperiod that special circumstances require an extension of time for conducting the review. If an extension of time for conducting the review is required,and decision of the Officer Committeedenial, the period for review and decision on the denial shall provide thebe extended by an additional 60 days. The claimant withshall receive written notice of the extension before the expiration of the initial 60-day period, specifying the circumstances requiring an extension and the date by which suchCommittee’s review shall be completed (which date shall not be later than 120 days after the date on which the Officer Committee received the request for review). The Officer Committee shall inform the claimant of its decision on review in a written notice, setting forth thedecision, together with specific reason(s)reasons for the decision and reference to Planthe pertinent provisions upon whichof the decision is based. A decision on review shall be final and binding on all persons for all purposes.Plan.

12.2Review

The claimant will have sixty days to request a review of Claim Denial. Ifthe denial by the Committee, which will provide a claim is denied,full and fair review. The request for review must be in whole or in part,writing delivered to the Committee. The claimant shall have the right to # request that the Officer Committee review the denial, #may review pertinent documents, and #he may submit issues and comments in writing, provided thatwriting. The decision by the claimant files a written request forCommittee with respect to the review with the Officer Committeemust be given within 60sixty days after the date on which the claimant received written notice from the Officer Committeereceipt of the denial. Within 60 days after the Officer Committee receives a properly filed request for review, the Officer Committee shall conduct such review and advise the claimant in writing of its decision on review,request, unless special circumstances require an extension of time(such as for conductinga hearing). In no event shall the review. If an extension of time for conducting the review is required, the Officer Committee shall provide the claimant with written notice of the extension before the expiration of the initial 60-day period, specifying the circumstances requiring an extension and the date by which such review shalldecision be completed (which date shall not be later thandelayed beyond 120 days after the date on which the Officer Committee receivedreceipt of the request for review).review. The Officer Committeedecision shall inform the claimant of its decision on reviewbe written in a written notice, setting forthmanner calculated to be understood by the claimant, and it shall include specific reason(s) for the decisionreasons and referencerefer to specific Plan provisions upon which the decision is based. A decision on review shall be final and binding on all persons for all purposes.as to its effect.

12.2Review

The claimant may request a review of Claim Denial. If a denied claim is denied,by writing the Committee in whole or in part,care of the claimant shall have the right to # request that the Officer Committee review the denial, # review pertinent documents, and # submit issues and comments in writing, provided that the claimant files a written request for review with the Officer CommitteePlan Administrator. The appeal must, however, be made within 60 days after the date on which the claimant received writtenclaimant's receipt of notice from the Officer Committee of the denial. Withindenial 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 after the Officer Committee receives a properly filed request fordays. If there are special circumstances requiring an extensive review, the Officer Committee shall conduct such review and advisenotify the claimant in writinga written notice within the original 60 day period of its receipt of the appeal and indicating that the decision will be delayed. A final decision on review, unless special circumstances require an extension of time for conducting the review. If an extension of time for conducting the review is required, the Officer Committeeappeal shall provide the claimant with written noticebe made within 120 days of the extension before the expirationCommittee's receipt of the initial 60-day period, specifying the circumstances requiring an extension and the date by which such review shall be completed (which date shall not be later than 120 days after the date on which the Officer Committee received the request for review). The Officer Committee shall inform the claimant of its decision on review in a written notice, setting forth the specific reason(s) for the decision and reference to Plan provisions upon which the decision is based. A decision on review shall be final and binding on all persons for all purposes.appeal.

12.2Review

Appeal Process. Following the denial of Claim Denial. If a claim is denied, in whole or in part,claim, the claimant shall have 60 days to request, in writing, a review of the right to # request thatdenial by the Officer Committee review the denial, #Committee, which will provide a full and fair review. The claimant may review pertinent documents, and #may submit issueswritten comments, documents, records and comments in writing, provided thatother information relating to the claim. In addition, upon request and free of charge, the claimant files a written request forshall be provided reasonable access to, and copies of, all documents, records and other information relevant to the claim. The Committee’s decision on review with the Officer Committeemust be given within 60 days after the date on which the claimant received written notice from the Officer Committeereceipt of the denial. Within 60 days after the Officer Committee receives a properly filed request for review,review unless the Officer Committee shall conduct such review and advise the claimant in writing of its decision on review, unlessdetermines that special circumstances require an extension of time for conductingprocessing the review. If an extension of time for conducting the review is required, the Officer Committee shall provide the claimant withclaim (such as a hearing), in which case, written notice of the extension beforeshall be provided to the claimant prior to the expiration of the initial 60-60 day period, specifyingperiod and the Committee shall have an additional 60 days from the expiration of the initial 60 day period to decide such claim. Any such notice of extension shall indicate the special circumstances requiring an extension of time and the date by which suchthe Committee expects to render its decision. The Committee’s review shall take into account all comments, documents, records and other information submitted by the claimant relating to the claim, without regard to whether such information was submitted or considered in the initial benefit determination. The Committee’s decision shall be completed (which dateprovided to the claimant in writing in a manner calculated to be understood by the claimant, and if such claim is denied, shall not be later than 120 days afterinclude # specific reasons for the dateadverse determination, # reference to the specific Plan provisions on which the Officer Committee received the request for review). The Officer Committee shall informdetermination is based, # a statement that the claimant is entitled to receive, upon request and free of its decision on review incharge, reasonable access to, and copies of, all documents, records and other information relevant to the claim and # a written notice, setting forthstatement of the specific reason(s) for the decision and referenceclaimant’s right to Plan provisions upon which the decision is based. A decision on review shall be final and binding on all persons for all purposes.bring an action under [Section 502] of ERISA.

12.2Review

Review of Claim Denial. IfUpon denial of a claim is denied,claim, in whole or in part, thea claimant shallor his duly authorized representative will have the right to #submit a written request thatto the Officer Committee for a full and fair review of the denial, # review pertinentdenied claim by filing a written notice of appeal with the Committee within 60 days of the receipt by the claimant of written notice of the denial of the claim. A claimant or the claimant’s authorized representative will have, upon request and free of charge, reasonable access to, and copies of, all documents, records, and #other information relevant to the claimant’s claim for benefits and may submit issues and comments in writing, provided thatwriting. The review will take into account all comments, documents, records, and other information submitted by the claimant files a written request for review withrelating to the Officer Committee within 60 days after the date on which the claimant received written notice from the Officer Committee of the denial. Within 60 days after the Officer Committee receives a properly filed request for review, the Officer Committee shall conductclaim, without regard to whether such review and advise the claimantinformation was submitted or considered in writing of its decision on review, unless special circumstances require an extension of time for conducting the review. If an extension of time for conducting the review is required, the Officer Committee shall provide the claimant with written notice of the extension before the expiration of the initial 60-day period, specifying the circumstances requiring an extension and the date by which such review shall be completed (which date shall not be later than 120 days after the date on which the Officer Committee received the request for review). The Officer Committee shall inform the claimant of its decision on review in a written notice, setting forth the specific reason(s) for the decision and reference to Plan provisions upon which the decision is based. A decision on review shall be final and binding on all persons for all purposes.benefit determination.

12.2Review

The claimant may request a review of Claim Denial. If aany denial of his or her claim is denied, in whole or in part,by written application to the claimant shall have the right to # request that the Officer Committee review the denial, # review pertinent documents, and # submit issues and comments in writing, provided that the claimant files a written request for review with the Officer Committee within 60 days after the date on which the claimant received written notice from the Officer Committeereceipt of the denial.notice of denial of such claim. Within 60 days after the Officer Committee receives a properly filed request for review, the Officer Committee shall conduct such review and advise the claimant in writing of its decision on review, unless(or, if special circumstances require an extension of time for conductingprocessing, 120 days, in which case notice of such special circumstances should be provided within the review. If an extensioninitial 60-day period) after receipt of timewritten application for conductingreview, the review is required, the Officer Committee shallwill provide the claimant with written notice of the extension before the expiration of the initial 60-day period, specifying the circumstances requiring an extension and the date by which such review shall be completed (which date shall not be later than 120 days after the date on which the Officer Committee received the request for review). The Officer Committee shall inform the claimant of its decision on review in a written notice, setting forthwriting, including, if the claimant's claim is not approved, specific reason(s)reasons for the decision and referencespecific references to the Plan provisions uponon which the decision is based. A decision on review shall be final and binding on all persons for all purposes.

12.2ReviewReview of Claim Denial. IfUpon denial of a claim is denied,claim, in whole or in part, the claimant shallClaimant or his duly authorized representative will have the right to #submit a written request thatto the Officer Committee for a full and fair review of the denial, # review pertinentdenied claim by filing a written notice of appeal with the Committee within 60 days of the receipt by the Claimant of written notice of the denial of the claim. A Claimant or the Claimant’s authorized representative will have, upon request and free of charge, reasonable access to, and copies of, all documents, records, and #other information relevant to the Claimant’s claim for benefits and may submit issues and comments in writing, provided thatwriting.. The review will take into account all comments, documents, records, and other information submitted by the claimant files a written request for review withClaimant relating to the Officer Committee within 60 days after the date on which the claimant received written notice from the Officer Committee of the denial. Within 60 days after the Officer Committee receives a properly filed request for review, the Officer Committee shall conductclaim, without regard to whether such review and advise the claimantinformation was submitted or considered in writing of its decision on review, unless special circumstances require an extension of time for conducting the review. If an extension of time for conducting the review is required, the Officer Committee shall provide the claimant with written notice of the extension before the expiration of the initial 60-day period, specifying the circumstances requiring an extension and the date by which such review shall be completed (which date shall not be later than 120 days after the date on which the Officer Committee received the request for review). The Officer Committee shall inform the claimant of its decision on review in a written notice, setting forth the specific reason(s) for the decision and reference to Plan provisions upon which the decision is based. A decision on review shall be final and binding on all persons for all purposes.benefit determination.

12.2Review

Review of Claim Denial. IfUpon denial of a claim is denied,claim, in whole or in part, thea claimant shallor his duly authorized representative will have the right to #submit a written request thatto the OfficerPlan Committee for a full and fair review of the denial, # review pertinentdenied claim by filing a written notice of appeal with the Plan Committee within 60 days of the receipt by the claimant of written notice of the denial of the claim. A claimant or the claimant’s authorized representative will have, upon request and free of charge, reasonable access to, and copies of, all documents, records, and #other information relevant to the claimant’s claim for benefits and may submit issues and comments in writing, provided thatexcept for privileged or confidential documentation. The review will take into account all comments, documents, records, and other information submitted by the claimant files a written request for review withrelating to the Officer Committee within 60 days after the date on which the claimant received written notice from the Officer Committee of the denial. Within 60 days after the Officer Committee receives a properly filed request for review, the Officer Committee shall conductclaim, without regard to whether such review and advise the claimantinformation was submitted or considered in writing of its decision on review, unless special circumstances require an extension of time for conducting the review. If an extension of time for conducting the review is required, the Officer Committee shall provide the claimant with written notice of the extension before the expiration of the initial 60-day period, specifying the circumstances requiring an extension and the date by which such review shall be completed (which date shall not be later than 120 days after the date on which the Officer Committee received the request for review). The Officer Committee shall inform the claimant of its decision on review in a written notice, setting forth the specific reason(s) for the decision and reference to Plan provisions upon which the decision is based. A decision on review shall be final and binding on all persons for all purposes.benefit determination.

12.2Review14.3Review of Claim Denial. Ifa Denied Claim. On or before sixty (60) days after receiving notice from the Committee that a claim ishas been denied, in whole or in part, a Claimant (or the claimant shall haveClaimant’s duly authorized representative) may file with the right to # request that the Officer Committee review the denial, # review pertinent documents, and # submit issues and comments in writing, provided that the claimant files a written request for review with the Officer Committee within 60 days after the date on which the claimant received written notice from the Officer Committee of the denial. Within 60 days after the Officer Committee receives a properly filed request for review, the Officer Committee shall conduct such review and advise the claimant in writing of its decision on review, unless special circumstances require an extension of time for conducting the review. If an extension of time for conducting the review is required, the Officer Committee shall provide the claimant with written noticedenial of the extension beforeclaim. The Claimant (or the expiration of the initial 60-day period, specifying the circumstances requiring an extension and the date by which such review shall be completed (which date shall not be later than 120 days after the date on which the Officer Committee received the request for review). The Officer Committee shall inform the claimant of its decision on review in a written notice, setting forth the specific reason(s) for the decision and reference to Plan provisions upon which the decision is based. A decision on review shall be final and binding on all persons for all purposes.Claimant’s duly authorized representative):

Load more...
Select clause to view document information.

Draft better contracts
faster with AllDrafts

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.