May a plan require that a claimant complete and file a form identifying any person authorized to act on his or her behalf with respect to a claim?
Yes, with one exception. The regulation provides that a reasonable claims procedure may not preclude an authorized representative of a claimant from acting on behalf of a claimant with respect to a benefit claim or appeal of an adverse benefit determination. The regulation also provides, however, that a plan may establish reasonable procedures for determining whether an individual has been authorized to act on behalf of the claimant. Completion of a form by the claimant identifying the authorized representative would be one method for making such a determination. The one exception is where a claim involves urgent care. In such instances, a plan must, without regard to the plan s procedures for identifying authorized representatives, permit a health care professional with knowledge of the claimant s medical condition (e.g., a treating physician) to act as the authorized representative of the claimant. This exception is intended to enable a health care professional to pursue a claim on b
Yes, with one exception. The regulation provides that a reasonable claims procedure may not preclude an authorized representative of a claimant from acting on behalf of a claimant with respect to a benefit claim or appeal of an adverse benefit determination. The regulation also provides, however, that a plan may establish reasonable procedures for determining whether an individual has been authorized to act on behalf of the claimant. Completion of a form by the claimant identifying the authorized representative would be one method for making such a determination. The one exception is where a claim involves urgent care. In such instances, a plan must, without regard to the plans procedures for identifying authorized representatives, permit a health care professional with knowledge of the claimants medical condition (e.g., a treating physician) to act as the authorized representative of the claimant. This exception is intended to enable a health care professional to pursue a claim on beh
Related Questions
- May a plan require that a claimant complete and file a form identifying any person authorized to act on his or her behalf with respect to a claim?
- What happens if I properly complete a Form I-9 and INS discovers that my employee is not actually authorized to work?
- Who is the authorized person to furnish the report under section 92E of the Transfer Pricing Regulation Act?
