Paid Claims Clause Samples
The Paid Claims clause defines the obligations and procedures related to claims that have already been settled or paid by an insurer or responsible party. In practice, this clause typically outlines how such claims are documented, reported, and possibly reimbursed if overpayments or errors are discovered. Its core function is to ensure transparency and proper accounting for claims that have been resolved, thereby preventing disputes over payment status and clarifying financial responsibilities between the parties.
Paid Claims. Paid Claims are described in Article 1-Paid Claims Definition of the Agreement.
Paid Claims. Paid Claims shall be included in Benefit Expense. The Department shall use Encounter Data claims for all dates of service during the Coverage Year and accepted by the Department within six (6) months after the end of the Coverage Year. If the Parties are unable to resolve Encounter Data systems issues prior to calculation of the MLR, the Parties will agree on an alternative method of calculating paid claims expense. Encounter Data claims covered by sub-capitation contracts shall be priced at Contractor’s Fee-For-Service rate for Covered Services. If Contractor does not have a published fee schedule for a Covered Service, the price on the sub- capitated service may not exceed one hundred ten percent (110%) of the Department’s Medicaid rate.
Paid Claims. In the event of a covered loss, payment is made directly to the Creditor and the Creditor decides how the payment will be used to preserve the value of our Collateral.
Paid Claims. To indemnify Indemnitee for expenses or liabilities of any type whatsoever (including, but not limited to, judgments, fines, ERISA excise taxes or penalties and amounts paid in settlement) to the extent such expenses or liabilities have been paid directly to Indemnitee by an insurance carrier under a policy of officers’ and directors’ liability insurance maintained by the Company or other indemnity provision provided or paid for by the Company; or