Notice of Claim Denial Sample Clauses

Notice of Claim Denial. If the Employee is denied a claim for benefits, the Administrative Committee, or its delegate, will provide such Employee with a written or electronic notice setting forth:

Notice of Claim Denial. The notice of denial will include the reasons for the denial, the specific Plan provisions on which the denial is based, a description of any additional information or material required to appeal the denial, the procedure and time limits for filing an appeal so that the Plan Administrator will reconsider its decision, and a statement of your right to xxx in court if the claim is again denied after an appeal. For adverse disability determinations, the notice of denial will also advise you of your right to request and receive (free of charge): • the identity of any medical or vocational experts whose advice was obtained on behalf of the plan in connection with the adverse benefit determination (without regard to whether such expert advice was relied upon by the joint board); • an explanation of any scientific or clinical judgment used in applying the Plan’s terms to your medical circumstances; • any policy, statement, or guidance concerning your medical condition; and • any rule, document, guideline, protocol, or other similar criterion if it was submitted to the Plan, considered by the Plan, or generated in the course of making the benefit determination.

Notice of Claim Denial. 1 f. Process requests for exclusion from the Settlement;

Notice of Claim Denial. The Plan Administrator or his delegate will provide adequate notice in writing to any employee, Participant or beneficiary whose claim for benefits under the Plan has been denied, setting forth the specific reasons for such denial. Subject to the express provisions of any applicable collective bargaining agreement, the employee, Participant or beneficiary will be given an opportunity for a full and fair review by the Plan Administrator (or his delegate) of the decision denying the claim. The employee, Participant or beneficiary will be given 60 days from the date of the notice denying such claim within which to request such review.

Notice of Claim Denial. If the plan determines that a claim provides insufficient information for the plan to pay the claim, the plan shall provide written or electronic notice of this determination to the person submitting the claim, promptly but in no instance later than thirty (30) calendar days following the date that the plan receives written or electronic notice of the claim, including the following information: