Dell 2008 Annual Report Download - page 166

9.5 Claims Review.
(a) In any case in which a claim for Plan benefits of a Member or Beneficiary is denied or modified, the Committee shall furnish written notice to the
claimant within ninety (90) days (or within 180 days if additional information requested by the Committee necessitates an extension of the
ninety-day period and, in which case, the claimant shall be informed of such extension prior to the end of the initial ninety (90)-day period),
which notice shall:
(1) State the specific reason or reasons for the denial or modification;
(2) Provide specific reference to pertinent Plan provisions on which the denial or modification is based;
(3) Provide a description of any additional material or information necessary for the Member, his beneficiary, or representative to perfect the
claim and an explanation of why such material or information is necessary; and
(4) Explain the Plan's claim review procedure as contained herein.
(b) In the event a claim for Plan benefits is denied or modified, if the Member, his Beneficiary, or a representative of such Member or Beneficiary
desires to have such denial or modification reviewed, he must, within sixty (60) days following receipt of the notice of such denial or
modification, submit a written request for review by the Committee of its initial decision. In connection with such request, the Member, his
Beneficiary, or the representative of such Member or Beneficiary may review any pertinent documents upon which such denial or modification
was based and may submit issues and comments in writing. Within sixty (60) days following such request for review the Committee shall, after
providing a full and fair review, render its final decision in writing to the Member, his Beneficiary, or the representative of such Member or
Beneficiary stating specific reasons for such decision and making specific references to pertinent Plan provisions upon which the decision is
based. If special circumstances require an extension of such sixty-day (60) period, the Committee's decision shall be rendered as soon as possible,
but not later than one-hundred-twenty (120) days after receipt of the request for review. If an extension of time for review is required, written
notice of the extension shall be furnished to the Member, Beneficiary, or the representative of such Member or Beneficiary prior to the
commencement of the extension period.
(c) If, upon appeal, the Committee shall grant the relief requested by the claimant, then, in addition, the Committee shall award to the claimant
reasonable fees and expenses of counsel, or any other duly authorized representative of claimant, which shall be payable from the Trust Fund.
(d) The Committee's notice of denial of benefits shall identify the address to which the claimant must forward his appeal.
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