10. CLAIM PROVISIONS promptly request more information or to resolve it, within 45 days after receiving a written claim or 30 days after receiving an electronic claim. Under a defective claim, interest will accrue from: · the 46th day after receipt of enough proof to confirm liability, if the claim is filed in writing and we request more information within 45 days; or · the 31st day after we receive enough proof to confirm liability, if the claim is filed by electronic means and we request more information within 30 days. A claim is considered "defective" when the first proof of claim is incomplete; any part of the claim is contested; or some other defect prevents prompt payment. What if your claim is denied? If we deny all or any part of your claim, you will receive a Written notice of denial stating: · the specific reason(s) for the denial; · the specific Policy provision(s) on which the denial is based; · your right to receive, upon request and free of charge, copies of all documents, records, and other information relevant to your claim for benefits; · a description of any additional material or information needed to prove entitlement to benefits and an explanation of why such material or information is necessary; · a description of the appeal procedures and time limits; · your right to bring a civil action under ERISA, §502(a), if applicable, following an adverse determination on review; and · the identity of any medical or vocational experts whose advice was obtained in connection with the claim, regardless of whether the advice was relied upon to deny the claim. Can you request a review of a claim denial? If all or part of your claim is denied, you may request in Writing a review of the denial within 60 days after receiving notice of denial. You may submit Written comments, documents, records or other information relating to your claim for benefits, and may request free of charge copies of all documents, records, and other information relevant to your claim for benefits. We will review the claim on receipt of the Written request for review, and will complete our review within 20 business days from the date we receive your request and all information needed to complete the review 60 days after the request has been received. If an extension of time is required to process the claim, we will notify you in Writing of the special circumstances requiring the extension and the date by which we expect to make a determination on review. The extension cannot exceed a period of 10 business days from the end of the initial period. We will notify you in writing of our decision within 5 business days after our investigation is complete. If a period of time is extended because you failed to provide information necessary to decide your claim, the period for making the decision on review is tolled from the date we send notice of the extension to you until the date on which you respond to the request for additional information. You will have at least 45 days to provide the specified information. What if your claim is denied on review? If we deny all or any part of your claim on review, you will receive a Written notice of denial stating: · the specific reasons for the denial; · the specific Policy provisions and reasons on which the denial is based; · your right to appeal the decision and information regarding the department or person to contact for information about the decision and your right to appeal; · your right to receive, upon request and free of charge, copies of all documents, records, and other information relevant to your claim for benefits; · your right to bring a civil action under ERISA, §502(a), if applicable; and 16-SD-C-01 Page30