Home Table of Contents

§ 407. Benefit Claims and Appeals.

4 CA ADC § 407Barclays Official California Code of Regulations

Barclays California Code of Regulations
Title 4. Business Regulations
Division 2. State Athletic Commission (Refs & Annos)
Chapter 1. Professional Boxing Rules
Article 12. Pension Plan
4 CCR § 407
§ 407. Benefit Claims and Appeals.
(a) Request for Information.
Any participating boxer or beneficiary may request information from the commission concerning rights or benefits under this article. The executive officer or his designee shall respond, in writing, not to exceed thirty (30) days, unless the failure to respond results from matters reasonably beyond the Administrator's control.
(b) Claim For Benefits.
The commission shall inform a claimant in writing within 30 days after receiving a claim whether the claim is complete and includes all information and documents necessary to establish the claim. The commission shall provide a written decision within 60 days after receipt of a complete claim. A written decision on each claim for benefits shall be provided to the person making the claim. If the claim is denied in any respect, the decision shall set forth the specific reasons for such denial, written in plain English, including:
(1) Specific references to pertinent Plan provisions on which the denial is based;
(2) An explanation of the Plan's review procedure for denied claims.
(c) Review Of Denied Claim.
Within ninety (90) days after receipt of decision denying a claim for benefits, the covered boxer or beneficiary making the claim or his/her authorized representative may file a written request for review. The commission shall notify the claimant that it has received the request for review and that the claimant may submit, within thirty (30) days from the date of the notification, a written statement and documents to give whatever facts or evidence the claimant feels bears upon the claim, review pertinent documents and records and submit issues and comments in writing. The commission shall make a full review of the record, including the written and oral information submitted by the claimant. Within thirty (30) days of the claimant's deadline to provide information, the commission shall render a decision and if the claim is again denied, the commission shall set forth the specific reasons for such denial written in plain English. Such decision shall contain the same information required by subsection (b), above.
(d) Time.
The filing of a claim or receipt of a notice of decision and any event starting a time period shall be deemed to commence with personal delivery signed for by the claimant or by affidavit of personal service, or the date of actual receipt for certified or registered mail (or date returned if delivery is refused or a claimant has moved without giving the commission, or its agents a forwarding address).

Credits

Note: Authority cited: Sections 18611 and 18881, Business and Professions Code. Reference: Sections 18881 and 18882, Business and Professions Code.
History
1. Change without regulatory effect of Note (Register 87, No. 5).
2. Repealer and new section heading, section and Note filed 4-26-96; operative 5-1-96 pursuant to Government Code section 11343.4(d) (Register 96, No. 17).
This database is current through 6/7/24 Register 2024, No. 23.
Cal. Admin. Code tit. 4, § 407, 4 CA ADC § 407
End of Document