Claims Procedure

All claims relating to a denial of benefits under the Educational Fund must be in writing and directed to the Fund Administrator. In the event your claim for benefits is denied, the Fund Administrator will furnish you with a written statement of the reasons for such denial, the Educational Fund provisions upon which the denial is based, and a statement of any requirements which you must meet in order to have your claim approved. You may obtain a review of such a denial if you make written request for a review to the Trustees no later than 61 days after you receive notice of the denial of your claim. As part of that request, you may submit to the Trustees any information you feel is relevant, and you or your representative will be given reasonable opportunity to review relevant documents and submit written comments. The Trustees will make their final decision at the first meeting which is at least 30 days after the receipt of your request for review. Under special circumstances, the Trustees may have to defer their decision for one additional meeting, but you will be informed promptly if this is necessary in your case.

Falsified Applications:

Should it be discovered that an applicant applied to the program by the use of fraudulent information or by any misrepresentations, the Trustees shall deny the application and may terminate the applicant from the program. The Trustees shall notify you, in writing, of their decision and the reasons therefore.

Right of Information:

For the purpose of determining the applicability of and implementation of the terms of these benefits, the Steamfitters’ Industry Educational Fund may, without the consent of or notice to any person, release or obtain any information necessary to determine acceptability of any potential or current covered person who benefits from the Fund's coverage.

In so acting, the Steamfitters’ Industry Educational Fund shall be free from any liability that may arise with regard to such action. Any covered person claiming benefits shall furnish, to the Fund, information which may be necessary to implement this provision.