Steps in Filing a Request for Review.
Time for Filing a Request for Review. If [Outdoor Products] (or in the case of a Section 16 Officer, the Committee) denies your claim, you may request a review of your claim by [Outdoor Products’] Chief Human Resources Officer (or in the case of a Section 16 Officer, the Committee). [Outdoor Products] must receive actual delivery of your written request for review within 60 days after the date you receive notice that your claim was denied.
Filing a Request for Review of a Denied Claim. You may file a request for review of a denied claim with [Outdoor Products], which will be forwarded to the Chief Human Resources Officer (or in the case of a Section 16 Officer, the Committee). Your request must include issues that you want considered in the review. You may submit written comments, documents, records, and other information relating to your claim. Upon request, you are entitled to receive free of charge reasonable access to and copies of the relevant documents, records, and information used in the claims process.
Response from [Outdoor Products] or Compensation Committee on Review. Within 60 days after the date [Outdoor Products] receives your request, you will receive a written or electronic notice of the decision or a notice describing the need for additional time (up to 60 additional days) to reach a decision. If you are notified that the Chief Human Resources Officer (or in the case of a Section 16 Officer, the Committee) needs additional time, the notice will describe the special circumstances requiring the extension and the date by which a decision is expected to be reached. If the Chief Human Resources Officer (or in the case of a Section 16 Officer, the Committee) affirms the denial of your claim, in whole or in part, you will receive a notice specifying the reasons, the Plan provisions on which it is based, notice that upon request you are entitled to receive free of charge reasonable access to and copies of the relevant documents, records, and information used in the claims process, and your right to file a civil action under section 502(a) of ERISA.
If the Committee Requests Further Information Regarding Your Claim on Review. If the Committee determines that further information is needed to complete the review of your denied claim, you will receive a written notice describing the additional information necessary to make the decision. You will then have 60 days from the date you receive the notice requesting additional information to provide it to the Committee. The time between the date the Committee sends the request to you and the date of receipt of the requested additional information from you shall not count against the 60-day period in which the Committee has to decide your claim on review. If the Committee does not receive a response, then the period by which the Committee must reach a decision shall be extended by the 60-day period provided to you to submit the additional information. Note: If special circumstances exist, this period may be further extended.
In General. The Committee will make all decisions on claims and review of claims. With respect to the review of original and denied claims, the Committee has the sole discretion, final authority, and responsibility to decide all factual and legal questions under this Plan. This includes interpreting and construing this Plan and any ambiguous or unclear terms, and determining whether a claimant is eligible for benefits and the amount of the benefits, if any, a claimant is entitled to receive. The Committee may hold hearings and reserves the right to delegate its authority to make decisions. The Committee may rely on any applicable statute of limitations as a basis to deny a claim. The Committee’s decisions are conclusive and binding on all parties. You may, at your own expense, have an attorney or representative act on your behalf, but the Committee reserves the right to require a written authorization for a person to act on your behalf.
Time Periods. The time period for review of your claim begins to run on the date [Outdoor Products] receives your written claim. Similarly, if you file a timely request for review, the review period begins to run on the date [Outdoor Products] receives your written request. In both cases, the time period begins to run regardless of whether you submit comments or information that you would like to be considered on review.
Limitations Period. If you file your claim within the required time, complete the entire claims procedure, and the Committee denies your claim after you request a review, you may sue over your claim (unless you have
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