Doctor Opinions and Third Medical Opinion Sample Clauses

Doctor Opinions and Third Medical Opinion. For purposes of determination of a Benefits Claim, the opinion of a Claimant’s treating Doctor shall not be given greater weight or deference than that of a Doctor obtained by the Plan Administrator. If there is a conflict between the opinions of the Doctor obtained by the Plan Administrator and the Claimant’s treating Doctor, the Claimant may request a Third Medical Opinion, paid for by the Employer. The Third Medical Opinion is binding on both the Plan Administrator and the Participant.
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Related to Doctor Opinions and Third Medical Opinion

  • Second Medical Opinions Members are entitled to a second medical opinion when disputing the appropriateness or necessity of a surgical procedure, or when subject to a serious injury or illness.

  • Second Opinions The Member may access a second opinion from a Network Provider regarding a medical diagnosis or treatment plan. The Member may request Preauthorization or may visit a KFHPWA-designated Specialist for a second opinion. When requested or indicated, second opinions are provided by Network Providers and are covered with Preauthorization, or when obtained from a KFHPWA-designated Specialist. Coverage is determined by the Member's EOC; therefore, coverage for the second opinion does not imply that the services or treatments recommended will be covered. Preauthorization for a second opinion does not imply that KFHPWA will authorize the Member to return to the physician providing the second opinion for any additional treatment. Services, drugs and devices prescribed or recommended as a result of the consultation are not covered unless included as covered under the EOC.

  • Second Opinion In any case where the Employer has reason to doubt the validity of the certification as outlined above, the Employer may require, at the Employer's expense, if not covered by insurance, that the eligible employee obtain the opinion of a second health care provider designated or approved by the Employer concerning any information certified by the original certification. The provider of the second opinion shall not be employed on a regular basis by the Employer.

  • AFFIRMATIONS, ASSURANCES AND CERTIFICATIONS 11 5.1 General Affirmations 11 5.2 Federal Assurances 11 5.3 Federal Certifications 11

  • Opinions Counterparty shall deliver to Dealer an opinion of counsel, dated as of the Premium Payment Date, with respect to the matters set forth in Sections 8(a) through (c) of this Confirmation; provided that any such opinion of counsel may contain customary exceptions and qualifications. Delivery of such opinion to Dealer shall be a condition precedent for the purpose of Section 2(a)(iii) of the Agreement with respect to each obligation of Dealer under Section 2(a)(i) of the Agreement.

  • Warranty Affirmations Assurances and Certifications 3.01 Federal Assurances Performing Agency further certifies that, to the extent Federal Assurances are incorporated into the Contract under the Signature Document, the Federal Assurances have been reviewed and that Performing Agency is in compliance with each of the requirements reflected therein.

  • Legal Opinion The Agent shall have received the opinions of Company Counsel required to be delivered pursuant to Section 7(m) on or before the date on which such delivery of such opinion is required pursuant to Section 7(m).

  • Regulatory Good Standing Certification - Explanation - Continued If Vendor responded to the prior attribute that "No", Vendor is not in good standing, Vendor must provide an explanation of that lack of good standing here for TIPS consideration. No response

  • WARRANTY, AFFIRMATIONS, ASSURANCES AND CERTIFICATIONS 12 5.1 WARRANTY 12 5.2 General Affirmations 13 5.3 Federal Assurances 13 5.4 Federal Certifications 13 5.5 State Assurances 13 ARTICLE VI. INTELLECTUAL PROPERTY 13 6.1 Ownership of Work Product 13 6.2 Grantee s Pre-Existing Works 14 6.3 THIRD PARTY IP 14 6.4 Agreements with Employees and Subcontractors 14 6.5 Delivery upon Termination or Expiration 15 6.6 SURVIVAL 15 6.7 System Agency Data 15 ARTICLE VII. PROPERTY 15

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