For Eligibility Determinations Clause Samples

For Eligibility Determinations. The Special Master’s determination of such appeal promptly will be communicated by the Claims Processor to the Claims Administrator, HOC, the SOC, and the Enrolled Claimant, or his/her Principal Responsible Attorney. Within seven (7) days following service of the Special Master’s determination, an Enrolled Claimant (or his/her Principal Responsible Attorney) may appeal such determination to the Claims Administrator by serving a form of appeal (to be agreed upon by the Parties) to the Claims Processor who shall direct such appeal to the Claims Administrator. The opposing party will have an opportunity to submit a response to the Enrolled Claimant’s appeal for review by the Claims Administrator. If an Enrolled Claimant (or his/her Principal Responsible Attorney) does not timely serve an appeal pursuant to this Section 4.4.2.2, the Special Master’s determination is final, binding, and Non-Appealable. 4.4.2.2.1 With respect to any timely appeal under Section 4.4.2.2, the Claims Administrator will review, for an abuse of discretion, whether the Enrolled Claimant meets the eligibility requirements for status as a Qualified Claimant based solely on: (1) the Claim Package before the Claims Processor when it issued the Eligibility Determination; (2) any Additional Claim Information provided by that Claimant to the Claims Processor prior to the issuance of the Claims Processor’s Award Determination; (3) any opposition statement submitted by the opposing party; and (4) the terms of this Agreement. No new or additional evidence may be submitted or considered in connection with any appeal.

For Eligibility Determinations the Settlement Administrator shall consider whether the submitting entity meets the definition of a Payer under the Settlement and whether the Payer Declaration and Claim Form is complete and timely.