6.10.550 Review of claims.
Within thirty (30) calendar days of the receipt of a claim, the Claims Administrator shall determine whether:
(A) The alleged act of employment discrimination occurred within three hundred sixty-five (365) days prior to receipt of the claim;
(B) The claim was received within one hundred eighty (180) calendar days of the date of receipt of the written notice provided pursuant to KTC 6.10.530(A);
(C) The claim as presented substantially complies with the content requirements described in KTC 6.10.530(B) and is signed under penalty of perjury;
(D) The incident or occurrence alleged by the claim arose out of a claimant’s employment in connection with, or relating to the operation of the Tribe’s gaming operation, gaming facility or gaming activities; and
(E) The claim seeks a remedy created by and available under this article.
These determinations shall be made solely for the purpose of determining whether to certify the claim for further proceedings, and shall not constitute a determination of the merits of the claim.
(F) In the event the Claims Administrator determines that a timely filed claim contains incomplete information or is missing any of the required items, the claimant shall be notified in writing that the claim is incomplete and shall identify the information and any documentation that claimant must provide in order to present a complete claim. Claimant shall be given at least twenty (20) business days from the date of notification to provide the requested information. If the requested information is not received within the time provided, or if the claim for other reasons does not comply with the requirements of this section, it will be rejected. In such case, the Claims Administrator shall send to the claimant, within thirty (30) days of its determination, a written “Rejection of Claim” stating all grounds for this action and informing claimant of the right to appeal the rejection of the claim to the Tribal Insurance Adjuster.
(G) If a claim meets all of the requirements of this section, the Claims Administrator shall undertake an investigation of the claim.
(H)
(1) If, during the course of the investigation it is determined that additional evidence or documentation is necessary, the claimant shall be sent a request for any such additional supporting evidence or documentation. Any such notice shall provide the claimant at least twenty (20) business days to respond.
(2) If the requested evidence or documentation is not received within the time provided, the claim shall be considered abandoned and, on this basis will be automatically denied. No award shall be made on an abandoned claim.
(3) The Claims Administrator shall send to the claimant, within thirty (30) days of making the determination of abandonment, written notice of denial of the claim that describes the grounds for the decision and informs the claimant of his or her right to appeal the decision to the Tribe’s insurance carrier. [Res. 18-R-039 § 8, 4/10/2018.]