2020 Code of Alabama
Title 11 - Counties and Municipal Corporations.
Title 3 - Provisions Applicable to Counties and Municipal Corporations.
Chapter 91A - Local Government Health Insurance Program.
Section 11-91A-9 - Discretion of Board; Review of Claims; Appeals.
Section 11-91A-9
Discretion of board; review of claims; appeals.
The board shall have complete discretion and final authority to interpret the terms and conditions of the program. The program shall require adequate notice in writing to any participant whose claim for benefits under the program has been denied, setting forth the specific reasons for such denial. Any participant whose claim for benefits has been denied shall be afforded a reasonable opportunity for a full and fair review by the claims administrator upon the written request made within 60 days of the date of denial and setting forth the specific reasons the participant believes the claim should be approved. The claims administrator shall provide a written final determination of the claim upon completion of the review. Appeal of a final decision made by the claims administrator shall be by legal action filed in the Circuit Court of Montgomery County.
(Act 2014-401, p. 1473, §9.)
