I have spent the last five years developing a keen understanding
of claim adjudication and drug reimbursement issues and medical terminology, as well.
Good working knowledge
of claims adjudication systems?
Not exact matches
The Arbitrator (i) shall apply internal laws
of the State
of New York consistent with the Federal Arbitration Act and applicable statutes
of limitations, or, to the extent (if any) that federal law prevails, shall apply the law
of the U.S., irrespective
of any conflict
of law principles; (ii) shall entertain any motion to dismiss, motion to strike, motion for judgment on the pleadings, motion for complete or partial summary judgment, motion for summary
adjudication, or any other dispositive motion consistent with New York or federal rules
of procedure, as applicable; (iii) shall honor
claims of privilege recognized at law; and (iv) shall have authority to award any form
of legal or equitable relief;
The appeal is to principles
of right that transcend intergroup rivalries and provide an objective standard
of reference for the disinterested
adjudication of competing
claims.
These includes a proposal for legislation preventing the use
of public money in settling sexual harassment
claims, removal
of forced arbitration provisions from employee contracts and a requirement that companies doing business with the state disclose the number
of sexual harassment
adjudications and nondisclosure agreements they've carried out.
Many
of the audience members asked about how societies are handling the
adjudication of harassment
claims.
(3) Investigation and
adjudication of claims.
In my proposal, the Treasury Secretary would initiate the process, but then would get handed off to a special bankruptcy court for
adjudication of claims.
In the event that a
claim for indemnification against such liabilities (other than the payment by the registrant
of expenses incurred or paid by a trustee, officer or controlling person
of the registrant in the successful defense
of any action, suit or proceeding) is asserted by such trustee, officer or controlling person in connection with the securities being registered, the registrant will, unless in the opinion
of its counsel the matter has been settled by controlling precedent, submit to a court
of appropriate jurisdiction the question whether such indemnification by it is against public policy as expressed in such Act and will be governed by the final
adjudication of such issue.
In the event that a
claim for indemnification against such liabilities (other than the payment by Registrant
of expenses incurred or paid by a trustee, officer or controlling person
of Registrant in the successful defense
of any action, suit or proceeding) is asserted by such trustee, officer or controlling person in connection with the securities being registered, Registrant will, unless in the opinion
of its counsel the matter has been settled by controlling precedent, submit to a court
of appropriate jurisdiction the question whether such indemnification by it is against public policy as expressed in the 1933 Act and will be governed by the final
adjudication of such issue.
To the fullest extent permitted by law, by your access to the Sites, you agree that: (i) any
claim, dispute or cause
of action regarding the Sites or these Terms shall be brought individually (NOT AS PART OF A CLASS ACTION) in the federal or state courts of the State of New York, and, such claim / dispute / cause of action will be resolved by a judge and THE RIGHT TO A JURY TRIAL IS HEREBY EXPRESSLY WAIVED; (ii) you consent to the personal jurisdiction of such courts as the exclusive tribunal for adjudication of any such claim / dispute / cause of action, expressly waiving any right of forum non convenience, change of venue or like right; (iii) your recovery will be limited to actual out - of - pocket costs involved in specifically accessing the Sites (if any) and you expressly waive your right to all other forms of recovery, including by way of example only, punitive, consequential, indirect, incidental, special and exemplary damages as well as attorneys» fees for bringing such claim / dispute / cause of action; and (iv) the court shall apply the law of the State of New York in adjudicating any such claim / dispute / cause of action, except for the choice of law / conflict of law rules of the State of New York (or of any other jurisdiction which would result in the application of the law of any jurisdiction other than the State of New York
of action regarding the Sites or these Terms shall be brought individually (NOT AS PART
OF A CLASS ACTION) in the federal or state courts of the State of New York, and, such claim / dispute / cause of action will be resolved by a judge and THE RIGHT TO A JURY TRIAL IS HEREBY EXPRESSLY WAIVED; (ii) you consent to the personal jurisdiction of such courts as the exclusive tribunal for adjudication of any such claim / dispute / cause of action, expressly waiving any right of forum non convenience, change of venue or like right; (iii) your recovery will be limited to actual out - of - pocket costs involved in specifically accessing the Sites (if any) and you expressly waive your right to all other forms of recovery, including by way of example only, punitive, consequential, indirect, incidental, special and exemplary damages as well as attorneys» fees for bringing such claim / dispute / cause of action; and (iv) the court shall apply the law of the State of New York in adjudicating any such claim / dispute / cause of action, except for the choice of law / conflict of law rules of the State of New York (or of any other jurisdiction which would result in the application of the law of any jurisdiction other than the State of New York
OF A CLASS ACTION) in the federal or state courts
of the State of New York, and, such claim / dispute / cause of action will be resolved by a judge and THE RIGHT TO A JURY TRIAL IS HEREBY EXPRESSLY WAIVED; (ii) you consent to the personal jurisdiction of such courts as the exclusive tribunal for adjudication of any such claim / dispute / cause of action, expressly waiving any right of forum non convenience, change of venue or like right; (iii) your recovery will be limited to actual out - of - pocket costs involved in specifically accessing the Sites (if any) and you expressly waive your right to all other forms of recovery, including by way of example only, punitive, consequential, indirect, incidental, special and exemplary damages as well as attorneys» fees for bringing such claim / dispute / cause of action; and (iv) the court shall apply the law of the State of New York in adjudicating any such claim / dispute / cause of action, except for the choice of law / conflict of law rules of the State of New York (or of any other jurisdiction which would result in the application of the law of any jurisdiction other than the State of New York
of the State
of New York, and, such claim / dispute / cause of action will be resolved by a judge and THE RIGHT TO A JURY TRIAL IS HEREBY EXPRESSLY WAIVED; (ii) you consent to the personal jurisdiction of such courts as the exclusive tribunal for adjudication of any such claim / dispute / cause of action, expressly waiving any right of forum non convenience, change of venue or like right; (iii) your recovery will be limited to actual out - of - pocket costs involved in specifically accessing the Sites (if any) and you expressly waive your right to all other forms of recovery, including by way of example only, punitive, consequential, indirect, incidental, special and exemplary damages as well as attorneys» fees for bringing such claim / dispute / cause of action; and (iv) the court shall apply the law of the State of New York in adjudicating any such claim / dispute / cause of action, except for the choice of law / conflict of law rules of the State of New York (or of any other jurisdiction which would result in the application of the law of any jurisdiction other than the State of New York
of New York, and, such
claim / dispute / cause
of action will be resolved by a judge and THE RIGHT TO A JURY TRIAL IS HEREBY EXPRESSLY WAIVED; (ii) you consent to the personal jurisdiction of such courts as the exclusive tribunal for adjudication of any such claim / dispute / cause of action, expressly waiving any right of forum non convenience, change of venue or like right; (iii) your recovery will be limited to actual out - of - pocket costs involved in specifically accessing the Sites (if any) and you expressly waive your right to all other forms of recovery, including by way of example only, punitive, consequential, indirect, incidental, special and exemplary damages as well as attorneys» fees for bringing such claim / dispute / cause of action; and (iv) the court shall apply the law of the State of New York in adjudicating any such claim / dispute / cause of action, except for the choice of law / conflict of law rules of the State of New York (or of any other jurisdiction which would result in the application of the law of any jurisdiction other than the State of New York
of action will be resolved by a judge and THE RIGHT TO A JURY TRIAL IS HEREBY EXPRESSLY WAIVED; (ii) you consent to the personal jurisdiction
of such courts as the exclusive tribunal for adjudication of any such claim / dispute / cause of action, expressly waiving any right of forum non convenience, change of venue or like right; (iii) your recovery will be limited to actual out - of - pocket costs involved in specifically accessing the Sites (if any) and you expressly waive your right to all other forms of recovery, including by way of example only, punitive, consequential, indirect, incidental, special and exemplary damages as well as attorneys» fees for bringing such claim / dispute / cause of action; and (iv) the court shall apply the law of the State of New York in adjudicating any such claim / dispute / cause of action, except for the choice of law / conflict of law rules of the State of New York (or of any other jurisdiction which would result in the application of the law of any jurisdiction other than the State of New York
of such courts as the exclusive tribunal for
adjudication of any such claim / dispute / cause of action, expressly waiving any right of forum non convenience, change of venue or like right; (iii) your recovery will be limited to actual out - of - pocket costs involved in specifically accessing the Sites (if any) and you expressly waive your right to all other forms of recovery, including by way of example only, punitive, consequential, indirect, incidental, special and exemplary damages as well as attorneys» fees for bringing such claim / dispute / cause of action; and (iv) the court shall apply the law of the State of New York in adjudicating any such claim / dispute / cause of action, except for the choice of law / conflict of law rules of the State of New York (or of any other jurisdiction which would result in the application of the law of any jurisdiction other than the State of New York
of any such
claim / dispute / cause
of action, expressly waiving any right of forum non convenience, change of venue or like right; (iii) your recovery will be limited to actual out - of - pocket costs involved in specifically accessing the Sites (if any) and you expressly waive your right to all other forms of recovery, including by way of example only, punitive, consequential, indirect, incidental, special and exemplary damages as well as attorneys» fees for bringing such claim / dispute / cause of action; and (iv) the court shall apply the law of the State of New York in adjudicating any such claim / dispute / cause of action, except for the choice of law / conflict of law rules of the State of New York (or of any other jurisdiction which would result in the application of the law of any jurisdiction other than the State of New York
of action, expressly waiving any right
of forum non convenience, change of venue or like right; (iii) your recovery will be limited to actual out - of - pocket costs involved in specifically accessing the Sites (if any) and you expressly waive your right to all other forms of recovery, including by way of example only, punitive, consequential, indirect, incidental, special and exemplary damages as well as attorneys» fees for bringing such claim / dispute / cause of action; and (iv) the court shall apply the law of the State of New York in adjudicating any such claim / dispute / cause of action, except for the choice of law / conflict of law rules of the State of New York (or of any other jurisdiction which would result in the application of the law of any jurisdiction other than the State of New York
of forum non convenience, change
of venue or like right; (iii) your recovery will be limited to actual out - of - pocket costs involved in specifically accessing the Sites (if any) and you expressly waive your right to all other forms of recovery, including by way of example only, punitive, consequential, indirect, incidental, special and exemplary damages as well as attorneys» fees for bringing such claim / dispute / cause of action; and (iv) the court shall apply the law of the State of New York in adjudicating any such claim / dispute / cause of action, except for the choice of law / conflict of law rules of the State of New York (or of any other jurisdiction which would result in the application of the law of any jurisdiction other than the State of New York
of venue or like right; (iii) your recovery will be limited to actual out -
of - pocket costs involved in specifically accessing the Sites (if any) and you expressly waive your right to all other forms of recovery, including by way of example only, punitive, consequential, indirect, incidental, special and exemplary damages as well as attorneys» fees for bringing such claim / dispute / cause of action; and (iv) the court shall apply the law of the State of New York in adjudicating any such claim / dispute / cause of action, except for the choice of law / conflict of law rules of the State of New York (or of any other jurisdiction which would result in the application of the law of any jurisdiction other than the State of New York
of - pocket costs involved in specifically accessing the Sites (if any) and you expressly waive your right to all other forms
of recovery, including by way of example only, punitive, consequential, indirect, incidental, special and exemplary damages as well as attorneys» fees for bringing such claim / dispute / cause of action; and (iv) the court shall apply the law of the State of New York in adjudicating any such claim / dispute / cause of action, except for the choice of law / conflict of law rules of the State of New York (or of any other jurisdiction which would result in the application of the law of any jurisdiction other than the State of New York
of recovery, including by way
of example only, punitive, consequential, indirect, incidental, special and exemplary damages as well as attorneys» fees for bringing such claim / dispute / cause of action; and (iv) the court shall apply the law of the State of New York in adjudicating any such claim / dispute / cause of action, except for the choice of law / conflict of law rules of the State of New York (or of any other jurisdiction which would result in the application of the law of any jurisdiction other than the State of New York
of example only, punitive, consequential, indirect, incidental, special and exemplary damages as well as attorneys» fees for bringing such
claim / dispute / cause
of action; and (iv) the court shall apply the law of the State of New York in adjudicating any such claim / dispute / cause of action, except for the choice of law / conflict of law rules of the State of New York (or of any other jurisdiction which would result in the application of the law of any jurisdiction other than the State of New York
of action; and (iv) the court shall apply the law
of the State of New York in adjudicating any such claim / dispute / cause of action, except for the choice of law / conflict of law rules of the State of New York (or of any other jurisdiction which would result in the application of the law of any jurisdiction other than the State of New York
of the State
of New York in adjudicating any such claim / dispute / cause of action, except for the choice of law / conflict of law rules of the State of New York (or of any other jurisdiction which would result in the application of the law of any jurisdiction other than the State of New York
of New York in adjudicating any such
claim / dispute / cause
of action, except for the choice of law / conflict of law rules of the State of New York (or of any other jurisdiction which would result in the application of the law of any jurisdiction other than the State of New York
of action, except for the choice
of law / conflict of law rules of the State of New York (or of any other jurisdiction which would result in the application of the law of any jurisdiction other than the State of New York
of law / conflict
of law rules of the State of New York (or of any other jurisdiction which would result in the application of the law of any jurisdiction other than the State of New York
of law rules
of the State of New York (or of any other jurisdiction which would result in the application of the law of any jurisdiction other than the State of New York
of the State
of New York (or of any other jurisdiction which would result in the application of the law of any jurisdiction other than the State of New York
of New York (or
of any other jurisdiction which would result in the application of the law of any jurisdiction other than the State of New York
of any other jurisdiction which would result in the application
of the law of any jurisdiction other than the State of New York
of the law
of any jurisdiction other than the State of New York
of any jurisdiction other than the State
of New York
of New York).
It gives us processes for adjudicating truth
claims, and imposes different evidentiary rules on
adjudication depending on the context and consequences (in criminal law proof beyond a reasonable doubt; in civil law proof on the balance
of probabilities).
... (1) to promote accuracy and certainty in the
adjudication of claims; (2) to provide fairness to persons who might be required to defend against
claims based on stale evidence; and (3) to prompt persons who might wish to commence
claims to be diligent in pursuing them in a timely fashion Having regard to these principles, and on the basis
of the facts before him, Justice Perell decided that the limitation period for the insured in Nasr began to run from the date upon which Intact formally denied the
claim in July 2013.
Rights
adjudication is no longer a mechanism that will allow those over whom power is
claimed in the name
of the collective to challenge the legitimacy
of that
claim, but instead, as Maus points out, «serves to empower and legitimate the state apparatus in programming itself».
«The
Adjudication of Claims Concerning Environmental Impact Assessment Before International Courts and Tribunals,» June 22, 2016 (International Union for the Conservation
of Nature, Academy
of Environmental Law Colloquium, Oslo, Norway)
«Justice Labrosse found that the Superior Court did not have jurisdiction to entertain this
claim, but that was not self - evident on the face
of the statement
of claim, so the issue required
adjudication by the court,» said Stephen Cavanagh
of Cavanagh LLP, an Ottawa firm retained by the insurer
of KISS.
To the surprise
of many observers, including, presumably, the petitioner and respondent in Executive Benefits, whose Supreme Court briefing focused, for the most part, on the issue
of consent, the Supreme Court chose not to address the question
of whether a party's consent to bankruptcy court
adjudication on a Stern
Claim may operate to effectively negate any constitutional concerns.
Of note, in Martin v. Workers» Compensation Board, the Supreme Court of Canada interpreted sections 126 and 161 of the WSIA as indicating that the Ontario legislature, like all other provincial legislatures in Canada, «contemplate [d] the consistent adjudication of claims through the application of policies»
Of note, in Martin v. Workers» Compensation Board, the Supreme Court
of Canada interpreted sections 126 and 161 of the WSIA as indicating that the Ontario legislature, like all other provincial legislatures in Canada, «contemplate [d] the consistent adjudication of claims through the application of policies»
of Canada interpreted sections 126 and 161
of the WSIA as indicating that the Ontario legislature, like all other provincial legislatures in Canada, «contemplate [d] the consistent adjudication of claims through the application of policies»
of the WSIA as indicating that the Ontario legislature, like all other provincial legislatures in Canada, «contemplate [d] the consistent
adjudication of claims through the application of policies»
of claims through the application
of policies»
of policies».
Jo specialises in
adjudication both in bringing high value fee
claim adjudications and defending professional negligence
adjudications including a multi million pound double
adjudication arising out
of a high profile PFI project.
That said, I would venture that trial fairness should operate as the guiding principle in this area, so if the plaintiff has decided that expert evidence from one specialty based on an examination
of the plaintiff is relevant to the
adjudication of her
claim at trial, courts should be loathe to deny the defence a fair opportunity to respond with expert evidence from the same specialty based on an assessment
of the plaintiff.
This trend stems from the recent Supreme Court
of Canada case, Hryniak v Mauldin, which held that «summary judgment rules must be interpreted broadly, favouring proportionality and fair access to affordable, timely and just
adjudication of claims.»
The course is accredited by the Chartered Institute
of Arbitrators and can lead to a second career in Arbitration,
Adjudication, Mediation or
Claims consultancy.
Pinsent Masons LLP remains at the forefront
of contractor work in the UK, with the practice handling a high volume
of adjudication and litigation
claims for the likes
of Balfour Beatty, Carillion and Kier Group.
One
of the major issues for injured workers from the late 1960s through the 1980s was the virtually hegemonic role played by doctors, who were employed full - time by the Workers» Compensation Board, in the
claims adjudication process.
Our contentious expertise includes
adjudication, ADR, arbitration and court proceedings and the resolution
of claims for defects, delay to completion, certification issues, loss
of engineer / architect's independence, loss and expense
claims, final account disputes, insurance matters and professional negligence
claims.
The Court noted that although use
of BRI in PTAB trials may result in some inconsistency with parallel district court actions, that risk «has long been present in our patent system, which uses different tracks — one in the Patent Office and one in the courts — for the review and
adjudication of patent
claims.»
Once you have reported your injury to your employer you must file the Employee's
Claim for Workers» Compensation Benefits and the Application for
Adjudication of Claim forms within one year
of your workplace accident.
Federally regulated employees have the option
of claiming unjust dismissal and pursuing a
claim under
adjudication provision
of the CLC or initiating a wrongful dismissal action.
The
claims process is administered by the Indian Residential School
Adjudication Secretariat (IRSAS), a quasi-judicial tribunal that operates independently from the parties to IRSSA, including the Government
of Canada.
Martin has over seven years
of experience representing disability claimants, helping them navigate the disability
claims process and representing them at hearings in the Office
of Disability
Adjudication and Review.
Given the number
of claims, claimants and damages involved, the class action is the appropriate method for fair and efficient
adjudication of the case, the lawsuit states.
He specialises in all aspects
of dispute resolution, particularly high value commercial and construction
claims, involving arbitration,
adjudication, mediation and High Court litigation.
But it is also true that they are both parts in delivering a unified message: that
of the common law courts» endorsement, sometimes ringing and sometimes more muted,
of the value
of access by the citizens to the
adjudication of rights
claims.
The other examples provided by commenters, such as arranging, conducting, or assistance with primary and appellate level review
of enrollee coverage appeals, also fall within the scope
of adjudication of health benefits
claims.
Response: We modify the definition
of payment to include resolution
of payment and coverage disputes; the final definition
of payment includes «the
adjudication * * *
of health benefit
claims.»
(i) Determinations
of eligibility or coverage (including coordination
of benefits or the determination
of cost sharing amounts), and
adjudication or subrogation
of health benefit
claims;
The Court upheld this procedure against
claims that it violates Article III or the Seventh Amendment jury right., holding that Congress had properly delegated inter partes review to the PTO, and that «the Seventh Amendment poses no independent bar to the
adjudication of that action by a nonjury factfinder.»
Main findings from the review
of caselaw on WSIB
adjudication (see also Chart) point to the regular disregard
of the treating health professional's medical opinion about whether return to work is safe; the reversal
of benefits promised to the most vulnerable injured workers (those with permanent disabilities approaching «lock - in»
of benefits); wrongful denial
of compensation based on «little or no evidence»
of pre-existing conditions; and undue targeting
of workers with psychological injuries for denial
of claims and for surveillance.
For health plans, designated record sets include, at a minimum, the enrollment, payment,
claims adjudication, and case or medical management record systems
of the plan.
[5] To that end, I conclude that summary judgment rules must be interpreted broadly, favouring proportionality and fair access to the affordable, timely and just
adjudication of claims.
Applicants for the position must have a law degree with at least 15 years at the bar, experience as a member
of the judiciary or in the
adjudication of claims, and have significant knowledge
of Canadian Aboriginal people and their history, culture and current issues.
«What's not in the judgment is my concern: a comedian comes under attack,
claims protection under the Charter
of Rights, and there's no
adjudication on whether this is protected speech or whether discrimination is a reasonable limit on the expression
of a comedian on stage,» Millar said in an interview.
The courts in Ontario have embraced the cultural shift endorsed by the Supreme Court
of Canada and are interpreting the summary judgment rules broadly, and favouring proportionality and fair access to affordable, timely and just
adjudication of claims.
Furthermore, trip interruption or evacuation are included in APRIL's signature «Stress Less» benefits, which bypass the frustrating
claims process via instant
adjudication of all applicable issues and inconveniences.
Because the
adjudication of each
claim is different, we are unable to provide you with an exact time frame for when we will complete the processing
of your
claim.
Determinations
of eligibility or coverage (including coordination
of benefits or the determination
of cost sharing amounts) and
adjudication or subrogation
of health benefit
claims
Our specialized underwriting divisions,
claims processing /
adjudication, small and large group case management, and international experts are committed to excellence and providing practical insurance solutions to all
of our customers.
The definition
of a «contributing entity» at § 153.20 provides that for the 2015 and 2016 benefit years, a contributing entity is (i) a health insurance issuer or (ii) a self - insured group health plan, including a group health plan that is partially self - insured and partially insured, where the health insurance coverage does not constitute major medical coverage, that uses a third party administrator (TPA) in connection with
claims processing or
adjudication, including the management
of internal appeals, or plan enrollment for services other than for pharmacy benefits or excepted benefits within the meaning
of section 2791 (c)
of the PHS Act.
Furthermore, these findings endorse our previous hypothesis, according to which the FR's authors suggested that the adoption
of the Italian Constitutional Court's line
of thinking remains the only viable solution for the safeguarding
of the interested individuals» right to an effective remedy and the
adjudication of their
claims» merits.
As a part
of your department, I hope to provide you with effective and accurate
claims adjudication.