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Agmt94 Managed Health Network
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Agmt94 Managed Health Network
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Last modified
7/5/2005 2:32:18 PM
Creation date
11/4/2004 2:05:29 PM
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Template:
Agreement
Contractor Name
Managed Health Network formerly Occupational Health Services
RMP File Number
304
Date
7/14/1994
Reso Ref
12379 12687 13007
Box
5858
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<br />Civil Procedure Section 1280, et seq.). <br /> <br />Arbitration is the final process for the resolution of any dispute <br />arising out of or relating to this Evidence of Coverage or the <br />Agreement, whether involving a claim in tort, contract or otherwise, <br />involving Subscribers, Family Members (whether a minor or an adult), <br />the heirs-at-law or personal representatives of a Subscriber or <br />Family Member, and OHS (including any of its agents or employees). <br />Members must settle' all such disputes by neutral, binding <br />arbitration according to the terms and conditions set forth here. <br />By enrolling in this plan, Members waive their constitutional right <br />(or any other such right) to a trial before a jury or judge <br />regarding such disputes, and any other right they may have to have <br />such disputes resolved in any manner other than as set forth here. <br /> <br />Judgment upon the award rendered by the arbitrator(s) may be entered <br />in any court having proper jurisdiction. The decision of the <br />arbitrator shall be final and binding. Each party is responsible <br />for their own attorney fees and for an equal share of the costs of <br />arbitration. The power of the arbitrator shall be limited to the <br />determination of the interpretation of the terms of the Group <br />Agreement and the Evidence of Coverage only and the arbitrator <br />expressly does not have the power to grant any other relief or award <br />or determine any change, modification, alteration, addition or <br />subtraction from any contractual provisions. section 1281.2(c) of <br />the California Code of Civil Procedure which allows a court to order <br />any case to trial if the case involves a party not privy (i.e., <br />bound by contract) to this provision, is expressly waived. <br /> <br />How to initiate arbitration proceedings <br /> <br />OHS is available to instruct Members how to initiate arbitration <br />proceedings. Generally, these arbitration proceedings are initiated <br />by the Member: (1) filing a petition in the Superior Court in the <br />county where the Agreement is to be performed (usually, the county <br />where the Member resides) or was made requesting that arbitration be <br />ordered, and (2) serving a copy of the petition and a written notice <br />of the time and place of the hearing thereof and any other papers <br />upon which the petition is based upon OHS' agent for service of <br />process at its principal place of business. <br /> <br />Medical malpractice disputes <br /> <br />Any dispute alleging medical malpractice, that is as to whether any <br />medical services or supplies covered under this Evidence of Coverage <br />were unnecessary or unauthorized by the Member or were improperly, <br />negligently or incompetently rendered, will be determined by <br />submission to arbitration as provided by California law, and not by <br />a lawsuit or resort to court process except to the extent California <br />law provides for judicial review of arbitration proceedings. ANY <br /> <br /> <br />- 14 - <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />, _"..."",,_ "_______.u,-¡--____.,_'.,.". ".." ., <br />
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