Decision on Review definition

Decision on Review. A decision on the review of a claim denied in whole or in part shall be made in the following manner:
Sample 1Sample 2Sample 3
Decision on Review. The decision on review of a claim denied in whole or in part by the Plan Administrator shall be made in the following manner: 16.4.1 Within 60 days following receipt by the Committee of the request for review (or within 120 days if special circumstances require an extension of time), the Committee shall notify the claimant in writing of its decision with regard to the claim. In the event of such special circumstances requiring an extension of time, written notice of the extension shall be furnished to the claimant prior to the commencement of the extension. If the decision on review is not furnished in a timely manner, the claim shall be deemed denied as of the close of the initial 60-day period (or the close of the extension period, if applicable).
Sample 1

Examples of Decision on Review in a sentence

  • Decision on Review - The Employer (or its designee) will render a decision upon review.

  • Decision on Review ------------------ The decision on the review of the denial of the claim shall be rendered by the Plan Administrator within sixty (60) days after the receipt of the request for review.

  • All claimants requesting a review of the decision denying their claim for benefits may employ counsel for purposes of the hearing.10.8 Decision on Review.

  • Decision on Review - The Plan Administrator (or its designee) will render a decision upon review.

  • No action at law or in equity shall be brought to recover benefits under the Plan more than two (2) years from the date of the Decision on Review.

  • The claimant shall receive written notice of the Decision on Review.

  • Manner of Content of Notification of Claims Decision on Review The Plan Administrator will provide claimants with written or electronic notification of a Plan’s benefit determination on review.

  • CLAIMS AND REVIEW PROCEDURE 63 14.1 Claims for Benefits and Inquiries 63 14.2 Denial of Claims 64 14.3 Review of Denied Claims 64 14.4 Decision on Review 65 14.5 Rules and Procedures on Review 65 14.6 Exhaustion of Remedies 65 ARTICLE XV.

  • Decision on Review of Denial...............................2 Section 14.07.

  • Decision on Review The Plan Committee, upon receipt of a request for review submitted by the claimant in accordance with subsection (b), shall conduct a review of its decision, and provide the claimant with written notice of the decision reached by the Plan Committee setting forth the specific reasons for the decision and specific references to the provisions of the Plan upon which the decision on review is based.

Related to Decision on Review

  • Decision-maker means a person who makes a determination regarding responsibility after the investigation has concluded. The Decision-maker cannot be the same person as the Title IX Coordinator, the Investigator, or the Appellate Decision-maker.

  • Review means a financial or operational audit, investigation, inspection or other form of review requested or required by the LHIN under the terms of LHSIA or this Agreement, but does not include the annual audit of the HSP’s financial statements;

  • independent review committee means the independent review committee of the investment fund established under National Instrument 81-107 Independent Review Committee for Investment Funds;

  • Independent review organization means an entity that is accredited to conduct independent external reviews of adverse benefit determinations.

  • Decision means a determination, action, vote, or disposition upon a motion, proposal, recommendation, resolution, order, ordinance, bill, or measure on which a vote by members of a public body is required and by which a public body effectuates or formulates public policy.

  • Evaluation Team means the team appointed by the City; “Information Meeting” has the meaning set out in section 2.2;

  • Board of Review or “board” means the state building code board of review created by Iowa Code section 103A.15. The three members of the board of review are appointed by the building code commissioner from among the membership of the building code advisory council.

  • Expedited review means an examination, in accordance with

  • Architectural Review Committee or “ARC” shall mean the architectural review committee established by the Organization to review plans submitted to the Organization for architectural review.

  • Utilization review means the prospective (prior to), concurrent (during) or retrospective (after) review of any service to determine whether such service was properly authorized, constitutes a medically necessary service for purposes of benefit payment, and is a covered healthcare service under this plan. WE, US, and OUR means Blue Cross & Blue Shield of Rhode Island. WE, US, or OUR will have the same meaning whether italicized or not. YOU and YOUR means the subscriber or member enrolled for coverage under this agreement. YOU and YOUR will have the same meaning whether italicized or not.

  • Adequacy Decision refers to a legally-binding decision issued by the European Commission allowing the transfer of Personal Data from the European Economic Area to a third country which has been considered adequate in terms of data protection safeguards.

  • Compliance Review means an inspection of the home, grounds, and files to determine compliance with these regulations.

  • Periodic Review means a review conducted by Ofwat for the purpose of determining one or more Price Controls in accordance with Part III of Condition B, but so that references in Part IV of Condition B to a Periodic Review shall exclude any review carried out under paragraph 11 of that Condition and shall include the determination by the Competition and Markets Authority of the relevant questions or, as the case may be, the disputed determination referred to it under paragraph 16 of Condition B;

  • Performance Review means a summative evaluation of a teacher other than a beginning teacher and used to determine whether the teacher’s practice meets school district expectations and the Iowa teaching standards, and to determine whether the teacher’s practice meets school district expectations for career advancement in accordance with Iowa Code section 284.7.

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

  • Institutional Review Board or “IRB” means, in accordance with 45 C.F.R. Part 46, 21 C.F.R. part 56, and other applicable regulations, an independent body comprising medical, scientific, and nonscientific members, whose responsibility is to ensure the protection of the rights, safety, and well-being of the Human Subjects involved in a study.