2021 Code of Alabama
Title 36 - Public Officers and Employees.
Chapter 29 - State Employees' Health Insurance Plan.
Article 1 - General Provisions.
Section 36-29-12 - Rules and Regulations; Notice of Denial of Claim; Review.

Universal Citation: AL Code § 36-29-12 (2021)

Section 36-29-12

Rules and regulations; notice of denial of claim; review.

The board shall promulgate such rules and regulations as may be required for the effective administration of the provisions of this chapter. The board shall have discretion and authority to interpret the terms and conditions of the plan. The plan shall require adequate notice in writing to any participant whose claim for benefits under the plan has been denied, setting forth the specific reasons for such denial and shall afford a reasonable opportunity to any participant whose claim for benefits has been denied for a full and fair review by the claims administrator upon the written request of the participant, within 60 days of the date of denial, setting forth the specific reasons for review. The claims administrator shall provide in writing a final determination of the claim. Review of a final decision by the claims administrator shall be by the Circuit Court of Montgomery County.

(Acts 1965, No. 833, p. 1564, §13; Act 2004-647, 1st Sp. Sess., p. 17, §1.)

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