2023 Archdiocese of Atlanta Meritain Group Plan Doc - Manual / Resource - Page 76
Statute of Limitations for Plan Claims and Appeals
Please note that no legal action may be commenced or maintained to recover benefits under the Plan more than 12
months after the final review/appeal decision by the Plan Administrator has been rendered (or deemed rendered).
Appointment of Authorized Representative
A Covered Person is permitted to appoint an authorized representative to act on his or her behalf with respect to a
benefit claim or appeal of a denial. An assignment of benefits by a Covered Person to a provider will not constitute
appointment of that provider as an authorized representative. To appoint such a representative, the Covered Person
must complete a form which can be obtained from the Plan Administrator or the Third Party Administrator. However,
in connection with a claim involving urgent care, the Plan will permit a health care professional with knowledge of the
Covered Person’s medical condition to act as the Covered Person’s authorized representative without completion of
this form. In the event a Covered Person designates an authorized representative, all future communications from the
Plan will be with the representative, rather than the Covered Person, unless the Covered Person directs the Plan
Administrator, in writing, to the contrary.
Physical Examinations
The Plan reserves the right to have a Physician of its own choosing examine any Covered Person whose Illness or
Injury is the basis of a claim. All such examinations will be at the expense of the Plan. This right may be exercised
when and as often as the Plan Administrator may reasonably require during the pendency of a claim. The Covered
Person must comply with this requirement as a necessary condition for coverage.
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