Claim Eligibility a. Eligible Class Members, during the Claim Period, may submit Claims provided that Class Members: (i) complete and timely submit In-Database Claim Forms or Standard Claim Forms; (ii) have Claims that are eligible for reimbursement; and (iii) do not opt out of the settlement. The In-Database Claim Forms or Standard Claim Forms shall be available on the settlement website and can be submitted in either hard-copy or on-line. In no event shall a Class Member be entitled to more than one payment per Mobile Device for the claims at issue.
Claim Eligibility. The Settlement Administrator shall review each Claim Form to determine if the Claim Form is timely and complies with the requirements of the Settlement. If information provided by a Claimant in submitting a Claim Form establishes, as determined by the Settlement Administrator, that the Claim is ineligible for payment under the Settlement for any reason, then the Settlement Administrator shall deny the Claim; provided, however, that the Settlement Administrator shall inform the Claimant of the denial in writing by mail and/or email and provide that Claimant with at least one further opportunity to establish his or her eligibility for payment under the Settlement. All Authorized Claimants shall be paid in accordance with the terms of the Settlement Agreement. The decisions of the Settlement Administrator as to Claim eligibility shall be final.
Claim Eligibility. Where a claim for Weekly Indemnity or Income Continuance benefits is denied by the insurance carrier, based on its assessment of the medical information it receives, the following terms and conditions shall be followed: The Company shall insure that a copy of the denial letter sent to the Company shall be forwarded to the SEA contemporaneously. If the employee or the Association on their behalf requests an Independent Medical Assessment within 45 days of the initial notification of denial of Weekly Indemnity or other income continuance claims, it shall be performed and the Company shall not raise any objections based on an employee’s return to work or based on a change in the employee’s medical condition at the time the request is received. The employee will be medically examined and assessed by a third party physician who is a specialist in the primary diagnosis, mutually agreed upon by the parties, and this assessment will be determinative of the employee’s eligibility for benefit and shall be final and binding on the parties with no further recourse to the grievance or arbitration process. The cost of this Independent Medical will be shared equally by the parties from their surplus funds of the respective disability benefit plan, and if there are no surplus funds the Company shall pay.
