Maksin Group
CLAIMS APPEAL PROCESS
If the Insured has a concern about a claim denial, the Insured may appeal the denial by submitting a written appeal request to Maksin Management Corp;
Assistance will be available to the Insured with respect to the appeal process. For assistance, the Insured may contact: Maksin Management Corp at 1-888-679-5676;
A written acknowledgment of each appeal will be sent to the Insured;
The Company will make a decision regarding the appeal within 30 days of the date the appeal is received or sooner if the insured’s health, life or ability to regain maximum function are in jeopardy, in which case a decision will be made within 72 hours of the date the appeal is received;
The Company will cooperate fully with representatives designated in writing by the Insured;
The Company will investigate all information submitted;
Written notification of our decision will be provided to the Insured, and, with the Insured’s permission, to the providers. The notice will explain the decision and provide the supporting documentation and clinical bases for our decision, and inform the insured of his or her right to request an independent review of the decision.
