Common use of Claims Payment Clause in Contracts

Claims Payment. All Contract claims services, with the exception of the adjudication of death claims not paid out as a lump sum, shall be performed by LMG on behalf of IIC. Notwithstanding, all such claims in the amount of $100,000 or greater shall be forwarded to IIC for review and approval prior to LMG's payment of the claim. All Contract claims shall be investigated, processed, and paid in accordance with the policies and procedures mutually agreed to by both parties. IIC will make its claims personnel and legal department available at IIC's expense to answer any questions that might arise from LMG's claims personnel relating to claims investigation, processing, and payment of Contract claims. In addition to the foregoing, in the case of a decision by LMG that a Contract claim should be denied, LMG shall communicate its proposed action to appropriate IIC personnel who must agree and approve the proposed claim denial before the claims decision is communicated to the policyholder or beneficiary. LMG will communicate appropriate details of any proposed claim denial in accordance with notification procedures to be jointly developed by the parties, which shall be in sufficient time to allow for a response by IIC and discussion with LMG to avoid violation of laws with respect to claims practices. If no response is received within five (5) business days of transmission, LMG shall have the right to proceed on the basis that IIC is in agreement with the decision to deny the claim. All claims paid by LMG from funds collected on behalf of, or for, IIC shall be paid only on drafts or checks of, and as authorized by, IIC. All monies received by LMG to pay claims on behalf of IIC shall be held in a fiduciary capacity. No deposits will be made into, nor disbursements made from, this fiduciary account, with the exception of claims and claims adjustment expenses. This fiduciary account will at all times have a balance equal to the amount deposited less claims and claims adjustment expenses paid. LMG is responsible for all correspondence with the claimant and preparation of the claim checks. Notwithstanding the foregoing, IIC shall provide legal support to LMG. For those claims referred to IIC by LMG, LMG will provide IIC with copies of the following:

Claims Payment. All Contract claims services, with Not later than 11:00 a.m. New York City time on (a) the exception fifth Business Day following the earlier of (i) any date on which any claim against the Company for payment being made under a TE Support Instrument and (ii) any date on which any written claim by a Customer is made that the Contractor or the applicable Supported Party has failed to make a payment to a Customer when such payment is due and payable under the terms of the adjudication of death claims not paid out as a lump sumapplicable Supported Obligation, shall be performed by LMG on behalf of IIC. Notwithstandingin each case, all such claims in the Contractor will pay the Company the amount of $100,000 or greater shall be forwarded to IIC claimed (the “Claimed Amount”); provided that if and for review and approval prior to LMG's payment of the claim. All Contract claims shall be investigated, processed, and paid in accordance with the policies and procedures mutually agreed to by both parties. IIC will make its claims personnel and legal department available at IIC's expense to answer any questions that might arise from LMG's claims personnel relating to claims investigation, processing, and payment of Contract claims. In addition to the foregoingso long as, in the case of a decision by LMG that a Contract claim should be deniedthis clause (ii), LMG shall communicate (x) the Contractor or applicable Supporting Party is disputing its proposed action to appropriate IIC personnel who must agree and approve the proposed claim denial before the claims decision is communicated liability to the policyholder or beneficiary. LMG will communicate appropriate details claiming Customer under the applicable Supported Obligation and (y) the Contractor is in compliance with its obligations under Article V of any proposed claim denial in accordance with notification procedures to be jointly developed by the parties, which shall be in sufficient time to allow for a response by IIC and discussion with LMG to avoid violation of laws this Agreement with respect to claims practices. If no response is received within five (5) business days of transmissionsuch dispute, LMG then until such disputed liability has been determined by a final non-appealable court judgment or arbitral award or pursuant to a written settlement or admission approved by the Company and the Contractor, the Contractor’s obligation to pay the Claimed Amount to the Company under this Section 4.01 shall not be deemed to have occurred and the right to proceed on the basis that IIC is in agreement with the decision to deny the claim. All claims paid by LMG from funds collected on behalf of, or for, IIC Unused TE Support Commitment shall be paid only on drafts or checks of, and as authorized by, IIC. All monies received reduced by LMG to pay claims on behalf of IIC shall be held in a fiduciary capacity. No deposits will be made into, nor disbursements made from, this fiduciary account, with the exception of claims and claims adjustment expenses. This fiduciary account will at all times have a balance an amount equal to the Claimed Amount (the period of such suspension, a “Dispute Period”) and (b) the first Business Day following any payment by the Company of a Claimed Amount under any TE Support Instrument, the Contractor will reimburse the Company the amount deposited less claims paid (the “Disbursed Amount”). A credit exposure fee will accrue on any Claimed Amount or Disbursed Amount that is not paid by the time required by the preceding sentence (after giving effect to any Dispute Period) (an “Outstanding Amount” and claims adjustment expenses paid. LMG is responsible for all correspondence with when the claimant and preparation Outstanding Amount (excluding Claimed Amounts during a Dispute Period) shall at any time exceed $1,000,000 in the aggregate, a “Payment Failure Event” shall be deemed to have occurred) at a per annum rate equal to the current interest rate determined at the default rate of the claim checks. Notwithstanding funded term loans under the foregoingCredit Agreement, IIC which fee shall provide legal support to LMG. For those claims referred to IIC by LMG, LMG will provide IIC with copies of the following:accrue daily and be payable in cash upon demand.

Claims Payment. All Contract Policy claims services, with the exception of the adjudication of death claims not paid out as a lump sum, shall be performed by LMG on behalf of IIC. Notwithstanding, all such claims in the amount of $100,000 or greater shall be forwarded to IIC for review and approval prior to LMG's payment of the claimHxxxxxx. All Contract Policy claims shall be investigated, processed, processed and paid in accordance with the policies and procedures mutually agreed to by both parties. IIC will make its claims Hxxxxxx'x claim personnel and legal department shall be made available at IIC's Hxxxxxx'x expense to answer any questions that might arise from LMG's claims personnel relating to claims investigation, processing, processing and payment of Contract Policy claims. In addition to the foregoing, in the case of a decision by LMG that a Contract Policy claim should be denied, LMG shall communicate its proposed action to appropriate IIC Hxxxxxx personnel who must agree and approve the proposed claim denial before the claims decision is communicated to the policyholder or beneficiaryfinalized. LMG will communicate appropriate details of any proposed claim denial in accordance with notification procedures to be jointly developed by the parties, which shall be in sufficient time to allow for a response by IIC and discussion with LMG to avoid violation of laws with respect to claims practices. If no response is received within five (5) business days of transmission, LMG shall have the right to proceed on the basis that IIC Hxxxxxx is in agreement with the decision to deny the claim. All claims paid by LMG from funds collected on behalf of, of or for, IIC for Hxxxxxx shall be paid on only on drafts or checks of, of and as authorized by, IICby Hxxxxxx. All monies received by LMG to pay claims on behalf of IIC Hxxxxxx shall be held in a fiduciary an administrative capacity. No deposits will be made into, nor disbursements made from, from this fiduciary account, with the exception of claims and claims adjustment expenses. This fiduciary account will at all times have a balance equal to the amount deposited less claims and claims adjustment expenses paid. LMG is responsible for all correspondence with the claimant and preparation of the claim checks. Notwithstanding the foregoing, IIC shall provide legal support to LMG. For those claims referred to IIC Hxxxxxx by LMG, LMG will provide IIC Hxxxxxx with copies of the following:

Claims Payment. All Contract Policy claims services, with the exception of the adjudication of death claims not paid out as a lump sum, shall be performed by LMG on behalf of IIC. Notwithstanding, all such claims in the amount of $100,000 or greater shall be forwarded to IIC for review and approval prior to LMG's payment of the claimTransamerica. All Contract Policy claims shall be investigated, processed, processed and paid in accordance with the policies and procedures mutually agreed to by both parties. IIC will make its Transamerica's claim personnel who are specified in LMG's claims personnel and legal department manual, (approved by Transamerica), shall be made available at IICTransamerica's expense to answer any questions that might arise from LMG's claims personnel relating to claims investigation, processing, processing and payment of Contract Policy claims. In addition to the foregoing, in the case of a decision by LMG that a Contract Policy claim should be denied, LMG shall communicate its proposed action to appropriate IIC Transamerica personnel who must agree and approve the proposed claim denial before the claims decision is communicated to the policyholder or beneficiaryfinalized. LMG will communicate appropriate details of any proposed claim denial in accordance with notification procedures to be jointly developed by the parties, which shall be in sufficient time to allow for a response by IIC and discussion with LMG to avoid violation of laws with respect to claims practices. If no response is received within five (5) business days of transmission, LMG shall have the right to proceed on the basis that IIC Transamerica is in agreement with the decision to deny the claim. All claims paid by LMG from funds collected on behalf of, of or for, IIC for Transamerica shall be paid on only on drafts or checks of, of and as authorized by, IICby Transamerica. All monies received by LMG to pay claims on behalf of IIC Transamerica shall be held in a fiduciary an administrative capacity. No deposits will be made into, nor disbursements made from, from this fiduciary account, with the exception of claims and claims adjustment expenses. This fiduciary account will at all times have a balance equal to the amount deposited less claims and claims adjustment expenses paid. LMG is responsible for all correspondence with the claimant and preparation of the claim checks. Notwithstanding the foregoing, IIC shall provide legal support to LMG. For those claims referred to IIC Transamerica by LMG, LMG will provide IIC Transamerica with copies of the following:: 1) Policy records ( including but not limited to: all correspondence relating to the policy) 2) All correspondence with the claimant. 3) Diary screens. 4) Claim proofs.

Claims Payment. All Contract Policy claims services, with the exception of the adjudication of death claims not paid out as a lump sum, shall be performed by LMG on behalf of IIC. Notwithstanding, all such claims in the amount of $100,000 or greater shall be forwarded to IIC for review and approval prior to LMG's payment of the claimXxxxxxx. All Contract Policy claims shall be investigated, processed, processed and paid in accordance with the policies and procedures mutually agreed to by both parties. IIC will make its claims Xxxxxxx'x claim personnel and legal department shall be made available at IIC's Xxxxxxx'x expense to answer any questions that might arise from LMG's claims personnel relating to claims investigation, processing, processing and payment of Contract Policy claims. In addition to the foregoing, in the case of a decision by LMG that a Contract Policy claim should be denied, LMG shall communicate its proposed action to appropriate IIC Xxxxxxx personnel who must agree and approve the proposed claim denial before the claims decision is communicated to the policyholder or beneficiaryfinalized. LMG will communicate appropriate details of any proposed claim denial in accordance with notification procedures to be jointly developed by the parties, which shall be in sufficient time to allow for a response by IIC and discussion with LMG to avoid violation of laws with respect to claims practices. If no response is received within five (5) business days of transmission, LMG shall have the right to proceed on the basis that IIC Xxxxxxx is in agreement with the decision to deny the claim. All claims paid by LMG from funds collected on behalf of, of or for, IIC for Xxxxxxx shall be paid on only on drafts or checks of, of and as authorized by, IICby Xxxxxxx. All monies received by LMG to pay claims on behalf of IIC Xxxxxxx shall be held in a fiduciary an administrative capacity. No deposits will be made into, nor disbursements made from, from this fiduciary account, with the exception of claims and claims adjustment expenses. This fiduciary account will at all times have a balance equal to the amount deposited less claims and claims adjustment expenses paid. LMG is responsible for all correspondence with the claimant and preparation of the claim checks. Notwithstanding the foregoing, IIC shall provide legal support to LMG. For those claims referred to IIC Xxxxxxx by LMG, LMG will provide IIC Xxxxxxx with copies of the following: