Common use of Content of Denial Clause in Contracts

Content of Denial. In the case of a complete or partial denial of the Claimant’s claim, a notice written in a manner calculated to be understood by Claimant shall set forth the specific reasons for the denial, references to the Program provisions upon which the denial is based, a description of any additional information or material necessary for the Claimant to perfect the benefit claim (together with an explanation of why the material or information is necessary), and an explanation of the Program’s claims appeal procedure.