UNDER THE PLAN.
ALL INTERPRETATIONS OF THE ADMINISTRATOR WITH
RESPECT TO ANY MATTER HEREUNDER SHALL BE FINAL, CONCLUSIVE AND BINDING ON ALL
PERSONS AFFECTED THEREBY.
NO MEMBER OF THE ADMINISTRATOR SHALL BE LIABLE FOR
ANY DETERMINATION, DECISION, OR ACTION MADE IN GOOD FAITH WITH RESPECT TO THE
PLAN.
THE COMPANY WILL INDEMNIFY AND HOLD HARMLESS THE MEMBERS OF THE
ADMINISTRATOR FROM AND AGAINST ANY AND ALL LIABILITIES, COSTS, AND EXPENSES
INCURRED BY SUCH PERSONS AS A RESULT OF ANY ACT, OR OMISSION, IN CONNECTION WITH
THE PERFORMANCE OF SUCH PERSONS' DUTIES, RESPONSIBILITIES, AND OBLIGATIONS UNDER
THE PLAN, OTHER THAN SUCH LIABILITIES, COSTS, AND EXPENSES AS MAY RESULT FROM
THE BAD FAITH, WILLFUL MISCONDUCT, OR CRIMINAL ACTS OF SUCH PERSONS
6.2
CLAIMS PROCEDURE.
THE EXECUTIVE, OR AFTER
THE EXECUTIVE'S DEATH THE BENEFICIARY MAY FILE A WRITTEN CLAIM WITH THE
ADMINISTRATOR SETTING FORTH THE NATURE OF THE BENEFIT CLAIMED, THE AMOUNT
THEREOF, AND THE BASIS FOR CLAIMING ENTITLEMENT TO SUCH BENEFIT.
THE
ADMINISTRATOR SHALL DETERMINE THE VALIDITY OF THE CLAIM AND COMMUNICATE A
DECISION TO THE CLAIMANT PROMPTLY AND, IN ANY EVENT, NOT LATER THAN NINETY (90)
DAYS AFTER THE DATE OF THE CLAIM. THE CLAIM MAY BE DEEMED BY THE CLAIMANT TO
HAVE BEEN DENIED FOR PURPOSES OF FURTHER REVIEW DESCRIBED BELOW IN THE EVENT A
DECISION IS NOT FURNISHED TO THE CLAIMANT WITHIN SUCH PERIOD.
EVERY CLAIM FOR
BENEFITS WHICH IS DENIED SHALL BE DENIED BY WRITTEN NOTICE SETTING FORTH IN A
MANNER CALCULATED TO BE UNDERSTOOD BY THE CLAIMANT (I) THE SPECIFIC REASON OR
REASONS FOR THE DENIAL, (II) SPECIFIC REFERENCE TO ANY PROVISIONS OF THE PLAN
(INCLUDING ANY INTERNAL RULES, GUIDELINES, PROTOCOLS, CRITERIA, ETC.) ON WHICH
THE DENIAL IS BASED, (III) DESCRIPTION OF ANY ADDITIONAL MATERIAL OR INFORMATION
THAT IS NECESSARY TO PROCESS THE CLAIM, AND (IV) AN EXPLANATION OF THE PROCEDURE
FOR FURTHER REVIEWING THE DENIAL OF THE CLAIM AND SHALL INCLUDE AN EXPLANATION
OF THE CLAIMANT'S RIGHT TO PURSUE LEGAL ACTION IN THE EVENT OF AN ADVERSE
DETERMINATION ON REVIEW.
(A)
REVIEW PROCEDURE.
WITHIN SIXTY (60) DAYS
AFTER THE RECEIPT OF A DENIAL ON A CLAIM, A CLAIMANT OR HIS/HER AUTHORIZED
REPRESENTATIVE MAY FILE A WRITTEN REQUEST FOR REVIEW OF SUCH DENIAL.
SUCH
REVIEW SHALL BE UNDERTAKEN BY THE ADMINISTRATOR AND SHALL BE A FULL AND FAIR
REVIEW.
THE CLAIMANT SHALL HAVE THE RIGHT TO REVIEW ALL PERTINENT DOCUMENTS.
THE CLAIMANT MAY SUBMIT WRITTEN COMMENTS, DOCUMENTS, RECORDS AND OTHER
INFORMATION RELATING TO THE CLAIM FOR BENEFITS, AND SUCH INFORMATION SHALL BE
TAKEN INTO ACCOUNT FOR PURPOSES OF THE REVIEW WITHOUT REGARD TO WHETHER SUCH
INFORMATION WAS SUBMITTED OR CONSIDERED IN THE INITIAL BENEFIT DETERMINATION.
THE ADMINISTRATOR SHALL ISSUE A DECISION NOT LATER THAN SIXTY (60) DAYS AFTER
RECEIPT OF A REQUEST FOR REVIEW FROM A CLAIMANT UNLESS SPECIAL CIRCUMSTANCES
REQUIRE A LONGER PERIOD OF TIME FOR PROCESSING, IN WHICH CASE WRITTEN NOTICE OF
THE EXTENSION, INDICATING THE SPECIAL CIRCUMSTANCES REQUIRING AN EXTENSION OF
TIME AND THE DATE BY WHICH THE PLAN EXPECTS TO RENDER THE DETERMINATION