Examples of Claim Determination Period in a sentence
Claim Determination Period: A Benefit Year, but, for a person, this does not include any part while the person has no coverage under This Program.
Claim Determination Period is the period of time, which must not be less than 12 consecutive months, over which Allowable Expenses are compared with total benefits payable in the absence of COB, to determine:(a) whether other insurance exists; and(b) how much each Plan will pay or provide.
For the purposes of this contract, Claim Determination Period is the period of time beginning with the effective date of coverage and ending 12 consecutive months following the date of loss or longer as may be determined by the proof of loss provision.
As each Claim is submitted, This Plan determines its obligation to pay for Allowable Expenses based on all Claims that were submitted up to that point in time during the Claim Determination Period.
For example, the cost difference between a private and semi-private hospital room is not an Allowable Expense, unless it is determined that the Claim Determination Period is a Contract Period.