Sentences with phrase «of claims adjudication»

Good working knowledge of claims adjudication systems?

I have spent the last five years developing a keen understanding of claim adjudication and drug reimbursement issues and medical terminology, as well.

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 Yorkof 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 YorkOF 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 Yorkof 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 Yorkof 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 Yorkof 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 Yorkof 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 Yorkof 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 Yorkof 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 Yorkof 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 Yorkof 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 Yorkof - 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 Yorkof 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 Yorkof 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 Yorkof 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 Yorkof 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 Yorkof 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 Yorkof 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 Yorkof 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 Yorkof 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 Yorkof 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 Yorkof 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 Yorkof any other jurisdiction which would result in the application of the law of any jurisdiction other than the State of New Yorkof the law of any jurisdiction other than the State of New Yorkof any jurisdiction other than the State of New Yorkof 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.