HOW TO SUBMIT A CLAIM. If You have a claim, please contact Our Administrator by mail at P.O. Box 1910, Arlington Heights, IL 00000-0000, by phone at (000) 000-0000, or via fax (000) 000-0000. You must provide Our Administrator with the Lessor’s itemized statement detailing the repairs or replacements required or Excess Wear & Use charges You are responsible for, and such other documentation as Our Administrator may request. You must file Your claim within thirty (30) days after receiving the Lessor’s itemized statement, or Your claim may be denied. Our Administrator reserves the right to conduct their own inspection of the Vehicle or require photographs of the Excess Wear & Use which is the subject of Your claim. The requirements set forth herein are in addition to any other Finance Agreement requirements.
HOW TO SUBMIT A CLAIM. How to Submit a Claim All claim forms, available from your Plan Administrator, must be correctly completed, dated and signed. Remember, always provide your Group Policy Number and your Certificate Number (found on your Group Benefit Card) to avoid any unnecessary delays in the processing of your claim. Your Plan Administrator can assist you in properly completing the forms, and answer any questions you may have about the claims process and your Group Benefit Program.
HOW TO SUBMIT A CLAIM i. Claims for Benefits must be filed on a standard Claim Form that is available in most dental offices. PPO and Premier Providers will fill out and submit your claims paperwork for you. Some Non-Delta Dental Providers may also provide this service upon your request. If you receive services from a Non-Delta Dental Provider who does not provide this service, you can submit your own claim directly to the dental plan. Please refer to the section titled “Dental Claim Form” for more information.
HOW TO SUBMIT A CLAIM. When the insured person wants to make an insurance claim, they must: > Notify Gritchen Affinity in writing of any losses that would invoke the insurance cover within five working days (brought forward to two working days in the event of theft). These timeframes will begin once the insured person discovers the loss that would entail the arrangement of cover. Once the timeframe has passed, the insured will be deprived of any right to compensation if the delay caused damage to the Company. > Automatically declare to Gritchen Affinity the cover subscribed on the same risk by other insurers. Contract no. 102 92 73 FOR UP-TO-DATE AND QUICK MANAGEMENT OF YOUR INSURANCE CLAIMS Log in to the website: xxx.xxxxxxx.xx (Send your documents and follow-up on the status of your case at any time) Via email: xxxxxxxx@xxxxxxx.xx FOR THE TRADITIONAL MANAGEMENT OF YOUR INSURANCE CLAIMS By post: Gritchen Affinity Service sinistre (Claims department) 00 xxx Xxxxxxx Xxxxxx - CS70139 18021 Bourges Cedex DO YOU NEED ASSISTANCE? When the incident occurs, in order to benefit from the cover defined above, it is imperative that you contact the Insurer’s Assistance Centre prior to any provision of services. A case number will then be issued, which alone will justify management of the services provided. THE ASSISTANCE CENTRE IS AVAILABLE 24 HOURS A DAY AND 7 DAYS A WEEK > By telephone on 00 00 00 00 00 Don’t forget to mention: - The contract number that appears on your subscription notice / insurance certificate Contract no. 102 92 73 - The nature of the assistance needed - The address and phone number where you can be reached. Gritchen Affinity 00, xxx Xxxxxxx Xxxxxx CS70139 - 18021 Bourges Cedex xxx.xxxxxxxx.xx EPIDEMIC EXTENSION Assurlodge Contract 102 92 73 The Epidemic extension can only be subscribed in addition to the ASSURLODGE NO. 10292 73 contract.
HOW TO SUBMIT A CLAIM. 1. Contact or have a representative of the repair facility contact ADMINISTRATOR’S Claim Department BEFORE any work is performed by calling (000) 000-0000.
HOW TO SUBMIT A CLAIM. 4.1 A Claim to receive services under this Plan must be submitted directly to Us, within 14 days of the occurrence of the accidental stain or accidental damage to the Covered Product covered by this Plan. You may contact Us by telephone at 0.000.000.0000 during normal business hours or by submitting a Claim at xxxxxxx.xxxxxxxxxx.xxx.
HOW TO SUBMIT A CLAIM. If the Covered Person is covered by Social Security, Medicare, or another insurance policy (private or not) he must obtain the reimbursement to which he is entitled before filing the claim. Statement of Social Security or other reimbursement and all medical bills relating to the claim must be enclosed (copies are acceptable only if the original statement of Social Security reimbursement is enclo- sed). The claim form must be submitted to the Insurer. In no case will the total of the refunds (this insurance contract plus Social Security or any other plan) ex- ceed the actual expense. Medical claims must be presented within ONE YEAR from the date the expenses are incurred.
HOW TO SUBMIT A CLAIM. The executor, or estate trustee, named in the will of the deceased Member’s may apply for the funds. If the Member left no will, then anyone appointed by a court of competent jurisdiction to manage the affairs of the deceased Member may apply for the funds. If the Member left no will and no one has been appointed by a court of competent jurisdiction to manage the affairs of the deceased Member, then the surviving spouse or closest next of kin may apply.
HOW TO SUBMIT A CLAIM. In order to process a Annual Distribution Policy claim for reimbursement for any given year you must submit an application to CGIFN no later than October 15th of the fiscal year of CGIFN (commencing October 15, 2013), along with your name, birth date, current address, telephone number, where you can be reached and status number (include a copy of your status card). Payments claimed for minor Members by a parent or guardian must be accompanied by the appropriate documentation, including proof of legal custody in certain circumstances. Claims are subject to approval by CGIFN and although we try to expedite and process as quickly as possible it can take from four to six weeks depending on the circumstances, the information submitted or lack of information. Our administrators may be required to contact a Member for further information. Payments will be issued in the first week of December, commencing in December 2013, for all approved applications. Attend in person or mail the required claim documents so that they will each CGIFN no later than October 15th to: Annual Distribution Policy Chippewas of Xxxxxxxx Island X.X.#0 Xxx X-00 Xxxxxx Xxxx, Ontario L0E 1R0 Telephone: (000) 000-0000
HOW TO SUBMIT A CLAIM. Benefits under this creditor insurance are payable to the Lender. In the event of a claim, You or Your representative must notify Us or the Lender within 30 days at the address or telephone number set out below. We or the Lender will send You or Your representative a claim form and instructions on submitting a claim with proof of loss. Any costs for the completion of a claim form or any documentation submitted in support of a claim are at You or Your representative’s expense. In the event of a death claim, We have the right, where allowed by law, to ask for an autopsy. In the event of an Involuntary Unemployment Insurance Benefit claim, We have the right to request information from Your former employer. Benefits will not be paid if You or Your representative refuse to provide a claim form or any documentation that is, or may be, reasonably required in support of a claim. You or Your representative must provide Us with the completed claim forms and written proof of the claim within 90 days of Your death, Your diagnosis of Covered Critical Illness, Your Involuntary Unemployment or Your Injury or Sickness. Failure to give Us notice of claim or provide Us with satisfactory proof of Your claim within this 90 day period does not invalidate the claim if the notice or proof is given by Your or Your representative as soon as reasonably possible, but in no event later than one year from the date of Your death, Your diagnosis of Covered Critical Illness, or Your Involuntary Unemployment if it is shown that it was not reasonably possible to give notice or provide proof within this one year period. You can contact Us at the following address or telephone number: Trans Global Insurance Company and Trans Global Life Insurance Company 00000 – 000 Xxxxxx XX Edmonton, Alberta, T5M 3S2 1-844-930-6022 TERMS USED IN THIS CERTIFICATE Application to Enroll means the agreement and acknowledgment You signed in order to enroll in this voluntary creditor insurance, attached to this Certificate, which outlines the Effective Date of coverage. Borrower means a customer who is named on the Promissory Note as the Borrower on an approved Loan by the Lender.
