Claim Decision definition

Claim Decision means the document used by the Defendant to advise Claimants of whether and to what extent their claims are approved or denied.
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Examples of Claim Decision in a sentence

  • Claim Decision TimeframeYou have 30 days from receiving a claim decision to accept, or the claim will be closed and the offer rescinded and case closed.

  • How to Appeal a Claim Decision How to Request an AppealIf you disagree with either a claim determination or a rescission of coverage determination, you can contact us in writing to formally request an appeal.Your request for an appeal should include: The patient's name and Policy number. The date(s) of Vision Service(s). The provider's name. The reason you believe the claim should be paid. Any documentation or other written information to support your request for claim payment.

  • Note that this caption differs from the Test Claim and the Parameters and Guidelines captions in that it includes only those sections that were approved for reimbursement in the Test Claim Decision.

  • Accept the reimbursement offered, which acceptance will be presumed if no completed Claim Decision and Option Selection Form or cure attempt is received by Settlement Administrator within 30 days of receipt of the letter.

  • Claim Decision - If we offer to cover a claim and the repair is not completed within 30 days the offer is automatically withdrawn and will not be paid.

  • In addition, travel and training costs are not included in the Parameters and Guidelines because those activities were not approved in the Test Claim Decision and the claimant did not request these costs as reasonably necessary to perform the mandated activity or submit substantial evidence to support such a request.

  • The Test Claim Decision approved the following reimbursable state-mandated activities:A.

  • Where the Claimant disputes the Claim Decision, the Claimant can seek a review of the Claims Decision by submitting a fully completed Request for Review Form to the Defendant, postmarked no later than 35 days from the date of the Claim Decision.

  • In addition, where a claim has been rejected in whole or in part, the Defendant shall promptly send a copy of the Claim Decision by email to Charles Laduca or such other individual as identified by Class Counsel.

  • If the Claimant does not resolve the identified deficiencies within 60 days from the date of the letter, the claim shall be denied, without prejudice to the Claimant’s right to file another Claim Form in accordance with the terms of this Agreement, and the Defendant shall promptly issue a Claim Decision denying the claim.

Related to Claim Decision

  • Final Decision means a final action of the commission determining the legal rights, duties, or privileges of any person. “Final decision” does not include preliminary, procedural, or intermediate actions by the commission, actions regulating the internal administration of the commission, or actions of the commission to enter into or refrain from entering into contracts or agreements with vendors to provide goods or services to the commission.

  • key decision * means an executive decision which is likely to:

  • Adverse decision means a decision reducing,

  • return decision means an administrative or judicial decision or act, stating or declaring the stay of a third-country national to be illegal and imposing or stating an obligation to return;

  • Land use decision means an administrative decision of a land use authority or appeal authority regarding:

  • Informed decision means a decision by a qualified patient, to request and obtain a prescription for medication that the qualified patient may self-administer to end his or her life in a humane and dignified manner, that is based on an appreciation of the relevant facts and after being fully informed by the attending physician of:

  • Proposed decision means the presiding officer’s recommended findings of fact, conclusions of law, decision, and order in a contested case in which the administrator did not preside.

  • Adequacy Decision means a decision issued by the European Commission that a country or region or a category of recipients in such country or region is deemed to provide an “adequate” level of data protection.

  • CPUC Decisions means CPUC Decisions 00-00-000, 00-00-000, 00-00-000, 00-00-000, 00-00-000, 00-00-000, 00-00-000, 00-00-000, 00-00-000, 00-00-000, 00-00-000, 00-00-000, 00-00-000, 00-00-000, 00-00-000, 00-00-000, 00-00-000, 00-00-000 and any other existing or subsequent decisions, resolutions or rulings related to resource adequacy, as may be amended from time to time by the CPUC.

  • the decisions means the decisions of the CMA on the questions which it is required to answer by virtue of section 35 of the Act;

  • Indemnification Claim Notice has the meaning set forth in Section 11.3.

  • Appellate Decision-maker means a person who considers and decides appeals of determinations regarding responsibility and dismissals of formal complaints. The Appellate Decision-maker cannot be the same person as the Title IX Coordinator, Investigator, or Decision-maker. The Appellate Decision-maker may be a school district employee, or a third party designated by the school district.

  • Claim Deadline means the last date by which a Claim submitted to the Administrator by a Settlement Class Member for a Claim Settlement Payment must be postmarked, which shall occur no later than fifteen (15) days after the Final Approval Hearing. All Claims postmarked on or before the Claim Deadline shall be timely, and all Claims postmarked after the Claim Deadline shall be untimely and barred from entitlement to any Claim Settlement Payment.

  • Final administrative decision means a decision by an agency

  • Labor law decision means an administrative merits determination, arbitral award or decision, or civil judgment, which resulted from a violation of one or more of the laws listed in the definition of “labor laws”.

  • Indemnification Claim has the meaning set forth in Section 10.3.

  • Record of Decision means a Record of Decision of an application for municipal planning approval as contemplated in section 55;

  • Unresolved Claim means a Claim, which at the relevant time, in whole or in part: (a) has not been Finally Determined to be a Proven Claim in accordance with the Amended Claims Procedure Order and this Plan; (b) is validly disputed in accordance with the Amended Claims Procedure Order; and/or (c) remains subject to review and for which a Notice of Allowance or Notice of Revision or Disallowance (each as defined in the Amended Claims Procedure Order) has not been issued to the Creditor in accordance with the Amended Claims Procedure Order as at the date of this Plan, in each of the foregoing clauses, including both as to proof and/or quantum;

  • Major Decision means:

  • Claim Notice has the meaning set forth in Section 8.4(a).

  • Review Panel means the panel, if any, appointed pursuant toRule 710 to review a completed Investigation Report and to determine whether a reasonable basis exists for finding a violation of the Rules and authorizing the issuance of a notice of charge pursuant to Rule 706.

  • Rejection Claim means a Claim arising from the rejection of an Executory Contract or Unexpired Lease pursuant to section 365 of the Bankruptcy Code.

  • Responsible Respondent means a Respondent that has the capability in all material respects to perform the scope of work and specifications of the Contract. In determining whether a Respondent is a Responsible Respondent, the Agency may consider various factors including, but not limited to, the Respondent’s competence and qualifications to provide the goods or services requested, the Respondent’s integrity and reliability, the past performance of the Respondent and the best interest of the Agency and the State.

  • Indemnified Claim has the meaning set forth in Section 8.2.

  • Response Action means the investigation, cleanup, removal, remediation, containment, control, abatement, monitoring of or any other response action to the presence of Regulated Substances or Contamination in, on, at, under or emanating from the Stadium Site, including the correction or abatement of any violation required pursuant to Environmental Laws or by a Governmental Authority.

  • Claim Objection Deadline means the first Business Day that is 180 days after the Effective Date, as may be extended by order of the Bankruptcy Court.