Claims And Appeals Procedure

Claims Review

Every effort will be made to complete the processing of all applications for Pension Benefits within 90 days after receipt by the Fund Office, or 45 days in situations involving applications for Disability Pensions. This period will begin upon receipt of your signed application form by the Fund Office without regard to whether all of the additional information necessary to decide the application has been submitted. Other periods of time set forth in this Section governing Claims and Appeals Procedures shall begin to run on the date the Plan first receives written notice of a claim or appeal.

In the event a decision on your benefit application cannot be made within the above processing period following receipt of your application, a letter will be sent to you prior to the expiration of the period explaining the special circumstances requiring an extension of time to take action on your application. The letter will also include the date by which a decision is expected to be reached, as well as any additional information necessary for you to complete your appeal.

If your application for Pension Benefits is denied in whole or in part, the Fund Office will provide you with a written or electronic notice that sets forth:

  • the reasons for the adverse benefit determination;
  • references to any plan provisions on which the determination was based;
  • a description of any additional material or information necessary for you to perfect the claim and an explanation of why such material or information is necessary;
  • a description of the plan’s review procedures and applicable filing deadlines including a statement of your right to bring a civil action under Section 502(a) of ERISA following an adverse benefit determination, and
  • any other information necessary for you to perfect your appeal.