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November 14, 2002 To: Lenders/Holders/Servicers Participating in the Health Education Assistance Loan (HEAL) Program Subject: HEAL Claim Review Process Lender Policy Memorandum L-2003-1 The HEAL Program is instituting a revised method for reviewing claims on or about January 20, 2003. This processing modification has been developed to operate on our new web-based Oracle database application referred to as HOPS (HEAL Online Processing System). A claims module was developed to facilitate comprehensive and standardized claim reviews using the attached HEAL Claim Review Process document. This document was based on HEAL statute, regulations, and policy pertinent to lender servicing, due-diligence, litigation, and claim submissions. As the loan servicing community is aware, we have shared the HEAL Claim Review Process document with you on several occasions over the past five years and received, discussed, and incorporated many of your suggestions. Therefore, HEAL servicers should be quite familiar with the claim processing changes incorporated in it. Primarily, we are instituting a practice of allowing only a single re-submission of a defective claim after the claim is edited in its entirety and an error report is generated and returned to a claimant. If a claim is rejected when re-submitted, the loans in the claim become permanently uninsured. Further, we are requiring a written, well documented explanation (detailed activity displayed in chronological date order) of why an account was in litigation for more than two years for each claim where litigation exceeded the 2-year time frame. Specific claim edits are enumerated in the HEAL System Edits for Claims Process portion of this document. These edits are built into our claim processing module and will be applied to each claim submitted for review and approval. The edits form the basis for determinations on the acceptability of each claim and any penalty assessments and should facilitate a clearer understanding for the claimant of specific requirements concerning time frames, dates, tolerances, documentation, etc. that are being used during a claim review. Any concerns you may have with the edits contained in this document should be brought to our attention prior to December 15, 2002 so that any modifications can be incorporated by the time HOPS goes into production on or about January 20, 2003. Please contact us at your earliest convenience to discuss any concerns, questions, and/or proposals. In the future, we would like to make this processing system available to loan servicers. We hope to give each loan servicer the ability to enter information directly into HOPS or send it electronically to us for upload into our database. We are sure you will agree, manual claim form submissions are time-consuming and cumbersome. We believe this new claim review system will benefit all parties by taking a substantial amount of the guesswork and subjectivity out of the claim review processBgiving claimants a clearer understanding of the decisions made on the acceptability of, and/or penalties imposed on, a given claim submission. Thank you for working with us to make the implementation of the new HEAL Claim Review Process System seamless and successful. Please contact Ms. Terri Ehrenfeld at (301) 443-5594 or Ms. Denise Sorrell at (301) 443-3831 of the HEAL Program with questions concerning this memorandum. Henry Lopez, Jr. Director HEAL CLAIM REVIEW PROCESS HEAL Claim Review Process November 14, 2002 All claims sent to the HEAL Program are date stamped and logged into the HEAL database the day they are received and a reviewer is assigned to the claim. All claims received by the HEAL Program will receive a complete and comprehensive review and will be processed using an automated system developed and maintained by the HEAL Program. Through a series of simple visual displays, the reviewer assigned to the claim will input information about the availability, accuracy, completeness, dates of required documents, and the dates of the critical events. Based on the decision rules embedded into the system algorithms, the system will inform the reviewer (i) which documents are missing, if any, and (ii) if the time lines specified in the HEAL regulations and policy memoranda have been met or not; if not, why and for what periods the accrued interest on the claim should be disallowed. The reviewer will then elect to: (1) approve the claim with or without disallowance of interest; (2) seek additional information from the lender/holder/servicer and place the claim in a REJECT HOLD (RH) status; or (3) reject the claim and send it back to the lender/holder/servicer and place the claim submission in a REJECT1 (R1) status. If this is a second submission, the claim submission is placed in a REJECT2 (R2) status, which is a final rejection of the claim and loans become permanently uninsured. An efficient and successful implementation of this automated system will require enhanced consultation and co-operation between the lenders/holders/servicers and the HEAL Program. Submission of documents in a claim package in a specific order will also be requested. The ordering of the documents is provided beginning on page 18 of this document. The HEAL System Edits for Claims Processing portion of this document will describe the conditions causing edit failures which will occur against the information the claimant provided. The lender/holder/servicer should use the various sections of this document to determine what information and documents are required for successfully processing a claim. References to when a penalty will occur is found throughout this entire document. If a claim package is found to have
In addition, pursuant to the HEAL regulation '60.41(e)(2), the interest on the approved re-submitted claim, if any, will be paid for up to 30 calendar days only from the date of the HEAL Program letter notifying the rejection of the original claim. The following documents are required for all claims: HRSA 510 - Lender=s Application for Insurance Claim (Note: Lender or Holder should read instructions on the claim form prior to completion.) 1. HRSA 510 must
be completed in its entirety. If the HRSA 510 is not completed in its entirety and/or the signature and date are not originals or are missing, the lender or holder will be notified by fax or e-mail and a new HRSA 510 must be submitted within 7 calendar days of the date of our notification of the deficiency. The claim at this time is placed in a REJECT HOLD (RH) status. If the properly completed form is not received within seven calendar days of the date of fax/e-mail notification to the lender/holder/servicer, the claim package will be placed in a REJECT1 (R1) status and returned to the lender/holder/servicer. If the claim type specified on the HRSA 510 can not be validated by the HEAL Program, the claim package will be placed in a REJECT HOLD (RH) status for 7 days to await validation of specific claim type. If the claim package contains loan(s) which are not in the HEAL database, the claim package will be placed in a REJECT1 (R1) status and returned to the lender/holder/servicer to be re-submitted without the uninsured loans. The lender/holder/servicer will be allowed a second time to submit the claim package correctly within 60 days (interest will only be paid for the first 30 days). Any errors found in this second submission of the claim package will render that the claim be placed in a REJECT2 (R2) status and make those loans permanently uninsured HEAL loans. B. Promissory Note 1. An original promissory note (or a legible copy of the promissory note(s) with an affidavit of loss and indemnification statement, pursuant to the Exception noted below) for each loan listed on the HRSA 510 must be submitted with the claim package. Exception: The HEAL Program will permit the use of affidavits of loss and indemnification in situations in which the lender or holder is unable to locate and submit the original promissory note. A legible copy of the promissory note must always accompany an affidavit of loss and indemnification statement. The lender or holder must exercise diligence in its attempts to locate the original note. Affidavits of loss and indemnification are intended to be used in exceptional circumstances only. Excessive use by a lender or holder will lead to a discontinuation of this exception for that particular lender or holder. 2. The promissory
note must be executed and properly signed and dated by the borrower. If any promissory note included in the claim package is not signed and dated by the borrower, the claim package will be rejected (R1 status). C. Documentation of Ownership of Loans The lender or holder must submit proof of ownership for all loans listed on HRSA 510 if the ownership of these loans can not be verified by the HEAL database. If the proof of ownership is not provided within seven calendar days of the date of fax/e-mail notification to the lender/holder/servicer, the claim package will be rejected (R1 status) and returned to the lender/holder/servicer. Endorsements from all previous loan owners must also be submitted for each loan or typed on the back of the promissory note. D. Student Loan Application 1. The claim package must
contain an original or legible copy of the student loan application with all
items completed for each loan listed on the HRSA 510. E. Disbursement Check or Electronic Fund Transfer (EFT) Disbursement Roster 1. For original HEAL
loans (not refinanced/consolidated loans) a lender or holder will provide
the HEAL Program with evidence of the disbursements within seven calendar
days of the date of fax/e-mail notification to the lender/holder/servicer.
F. Deferments 1. The claim package must contain original or legible copies of deferment forms for all deferments granted for loans listed on the HRSA 510. Exception: The HEAL Program permits the use of affidavits of loss and indemnification in situations in which the lender or holder is unable to locate and submit the original or a legible copy of a deferment form. The lender or holder must exercise diligence in its attempts to locate the original or a legible copy of the deferment form. Affidavits of loss and indemnification are intended to be used in exceptional circumstances only. Excessive use by a lender or holder will lead to a discontinuation of this exception for that particular lender or holder. 2. The claim package must
contain a separate deferment form for each eligible deferment period granted
to the borrower for loans listed on the HRSA 510 unless, the deferment was
granted retroactively, in which case a single deferment form prepared by the
lender may be provided to cover multiple deferment periods. Reference to
this would also be noted in the correspondence history. G. Repayment Schedule Form 1. The claim package must contain an original or legible copy of the first repayment schedule form issued for each loan listed on the HRSA 510. An issue date must be on each form. Any subsequent repayment schedule forms that were issued after the initial repayment schedule form need not be submitted to the HEAL Program with the claim package. Only the first repayment schedule is the required document. Exception: The HEAL Program permits the use of affidavits of loss and indemnification in situations in which the lender or holder is unable to locate and submit the original or a legible copy of the repayment schedule form. The lender or holder must exercise diligence in its attempts to locate the original or a legible copy of the repayment schedule form. Affidavits of loss and indemnification are intended to be used in exceptional circumstances only. Excessive use by a lender or holder will lead to a discontinuation of this exception for that particular lender or holder. 2. A repayment schedule form covering each loan listed on the HRSA 510 must be sent to the borrower at least 30 but not more than 60 calendar days before the expiration of the borrower=s grace period or a continuous period of deferment that started immediately after the expiration of the grace period. If the grace period has previously been used, the repayment schedule form must be sent to the borrower at least 30 but not more than 60 calendar days before the end of the last deferment period. The Abegin date@ on the repayment schedule form should be after the graduation date or withdrawal date, any deferments granted, and the completion of a 9-month grace period. For a consolidated loan, if the borrower was in repayment at the time of execution of the consolidated loan, a repayment form must be issued within 30 days of the execution date of the consolidated loan. H. Forbearance 1. The claim package must contain an original or legible copy of each forbearance request granted to the borrower for each loan listed on the HRSA 510. Exception: The HEAL Program permits the use of affidavits of loss and indemnification in situations in which the lender or holder is unable to locate and submit the original or a legible copy of a forbearance form. The lender or holder must exercise diligence in its attempts to locate the original or a legible copy of the deferment form. Affidavits of loss and indemnification are intended to be used in exceptional circumstances only. Excessive use by a lender or holder will lead to a discontinuation of this exception for that particular lender or holder. 2. The forbearance
certification must contain the signatures of both the borrower and the authorizing
official representing the lender or holder. The forbearance form must be
entirely completed, including borrower=s reason
for requesting forbearance, and the beginning and ending dates of the forbearance
period. Each forbearance period may not exceed 6 months unless it
is granted to cure litigations as per provisions of the HEAL Lender Policy
Memorandum Number L-1994-07. The claim package must contain a separate forbearance
certification for each forbearance period granted to the borrower for loans
listed on the HRSA 510 unless, the forbearance was granted retroactively,
in which case a single forbearance form prepared by the lender may be provided
to cover multiple forbearance periods. Reference to this would also be noted
in the correspondence history. Any change in time periods different that
stated on the forbearance form must be written on the form and initialed
by the lender. Notes attached to the form are unacceptable. If a lender/holder/servicer grants more than one Extended Forbearance (to cure a litigation) to a borrower, the amount of interest that accrues on the account during all but the first Extended Forbearance will not be payable in the event of filing a claim. The only exception to this restriction is that borrowers who refinance their HEAL loans may obtain two Extended Forbearances: one before their loans are refinanced and once following refinancing. Written justification must be included in the claim package for any extended forbearance to avoid a penalty for that time period as per provisions of the HEAL Lender Policy Memorandum L-2002-6. I. Loan Servicing History and Payment History The claim package must contain a loan servicing and payment history. This should include a detailed history of the account activity, including payments made from the date of the disbursement to the submission of the claim. This history should provide data verifying the documents submitted in the claim. Required activity includes the following: a. Graduation or withdrawal
date J. Principal and Interest Calculation Worksheet The claim package must contain a complete principal and interest calculation worksheet for all loans listed on the HRSA 510. The worksheet must include interest charged, compounding, payments, and a running balance from when the loans were disbursed until the date of the claim submission (principal and interest calculation worksheets, if any, from prior lenders/holders/servicers must also be included in the claims package but are not required to be recalculated unless a dispute arises). The final amount listed on the summary worksheet for all loans must match the total amount requested on HRSA 510. If the principal and interest calculation worksheet balance is different from the amount requested on the HRSA 510 by more than $1000, the discrepancies must be resolved within seven calendar days of the date of fax/e-mail notification to the lender/holder/servicer, otherwise the claim package will be placed in a REJECT1 (R1) status and returned to the lender/holder/servicer.1 Additional documentation required based on specific type of claim: A. Death Claim 1. Each death claim must
include an original or certified copy of the borrower=s death
certificate and must be received within 60 days of notification unless references
have been contacted. Interest will not be paid beyond 60 days from notification of death unless a lender can show that references have been contacted in an effort to acquire a death certificate where one has not been received. If the claim package is submitted later than 30 calendar days after lender=s or holder=s receipt of the death certificate, the Secretary will not pay interest that accrued from the 31st day until the day the claim was received by the HEAL Program (as evidenced by the HEAL receipt date stamp on the HRSA 510 form). If all loans held by a lender or holder at the time of submission of the claim are not included in the death claim package as confirmed by the HEAL database, the discrepancies must be resolved within seven calendar days of the date of fax/e-mail notification to the lender/holder/servicer, otherwise the claim package will be rejected and returned to the lender/holder/servicer. The re-filing of a rejected death claim will follow the policies set forth in the section ARe-submission of Rejected Claims@ in this document. B. Disability Claim 1. A lender or holder must receive a borrower=s medical documentation within 60 days of notification of the borrower=s disability to avoid an interest penalty. The borrower=s request for disability approval package must be sent to the DHHS within 15 days of receipt by the lender or holder to avoid an interest penalty. 3. Each disability claim package must have an original or legible copy of the DHHS Disability Approval Letter certifying the borrower for total and permanent disability. 4. The disability claim package must be filed within 30 calendar days of the date of the receipt of the DHHS Disability Approval Letter by the lender/holder/servicer. 5. All loans held by a lender or holder must be submitted in one disability claim package. If the claim was submitted later than 30 calendar days of the receipt of the DHHS Disability Approval Letter, the Secretary will not pay interest that accrued from the 31st day to the day the claim package was received by the HEAL Program (as evidenced by the HEAL receipt date stamp on the HRSA 510 form). If all loans held by a lender or holder at the time of submission of the claim are not included in the disability claim package, the claim package will be placed in a REJECT1 (R1) status. The re-filing of a rejected disability claim must follow the policies set forth in the ARe-submission of Rejected Claims@ section of this document. C. Default Claims 1. Low Balance Claims Claim packages submitted with loan balances of $300 or less are not required to be litigated. All other due diligence requirements must be met, however. The lender or holder is required to submit the claim package within 30 calendar days of the date of the lender/holder/servicer=s request for the 3rd pre-claims assistance letter. If the low balance claim is submitted beyond the 30 day limit allowed, the Secretary will not pay interest that accrued from the 31st day to the day the claim was received in the HEAL Program (as evidenced by the HEAL receipt date stamp on the HRSA 510 form). 2. Loans less than $5,000 disbursed prior to 11/04/88 Claim packages in which each loan has an original principal of less than $5,000 that were disbursed prior to 11/04/88 are excused from the litigation requirement. All other due diligence requirements must be met, however. The lender or holder is required to submit the claim within 30 calendar days of the date of the lender/holder/servicer=s request for the 3rd pre-claims assistance letter. If the claim with loans below $5,000 is submitted beyond the 30 day limit allowed, the Secretary will not pay interest that accrued from the 31st day to the day the claim was received in the HEAL Program (as evidenced by the HEAL receipt date stamp on the HRSA 510 form). 3. Loans less than $2,500 disbursed on or after 11/04/88 Claim packages in which each loan has an original principal of less than $2,500 and were disbursed on or after 11/04/88 are excused from the litigation requirement. All other due diligence requirements must be met, however. The lender or holder is required to submit the claim within 30 calendar days of the date of lender/holder/servicer=s request for the 3rd pre-claims assistance letter. If the claim with loans below $2,500 is submitted beyond the 30 day limit allowed, the Secretary will not pay interest that accrued from the 31st day up to the day the claim was received in the HEAL Program (as evidenced by the HEAL receipt date stamp on the HRSA 510 form). 4. Skip Claims a. Claim packages submitted
when the borrower could not be located are excused from the litigation requirement.
All other due diligence requirements must be met, however. The lender or
holder must use skip tracing activities as outlined in section 60.35(a)(2)
of the HEAL regulations. All skip tracing efforts must be documented. The
lender or holder is required to submit the claim within 30 calendar days of
the day the borrower is determined to be a skip. If the skip claim is submitted beyond the 30 day limit allowed, the Secretary will not pay interest that accrued from the 31st day to the day the claim was received in the HEAL Program (as evidenced by the HEAL receipt date stamp on the HRSA 510 form). The HEAL Program will also penalize for skip-tracing activity performed more than twice in a 24 month period as per provisions of the HEAL Lender Policy Memorandum L-2002-5.5. Unable to Serve a. If the claim package
contains litigations which are not in the HEAL database, the claim package
will be placed in a REJECT HOLD (RH) status until a resolution is made. A
special litigation reporting submission can be made by the lender/holder/servicer
to satisfy this requirement. Attempts to serve a borrower are dictated by the claim amount requested and whether the service is public or private.
c. The lender or holder
is required to submit the Summons and Complaint in the claim package. If the unable to serve claim is submitted beyond the 30 day limit allowed, the Secretary will not pay interest that accrued from the 31st day to the day the claim was received in the HEAL Program (as evidenced by the HEAL receipt date stamp on the HRSA 510 form). 6. Claims with Judgments a. The claim package must
contain a certified or exemplified copy of the judgment order signed and dated
by either the judge or the clerk of the court. As per HEAL regulation ' 60.40(c)(1)(ii), if a judgment claim is not filed within 60 calendar days of the date of the issuance of the judgment, the Secretary will not pay interest beyond this 60-day period. No interest penalties will be assessed if the lender/holder/servicer submits documentation verifying that written follow-up with the court was performed every 15 calendar days beyond this 60-day period to obtain a certified copy of the judgment from the court. However, the claim must still be filed within 30 calendar days of the receipt of the judgment by the lender/holder/servicer, otherwise, the Secretary will not pay interest that accrued from the 31st day to the day the claim was received by the HEAL Program (as evidenced by the HEAL receipt date stamp). Also, see HEAL Policy Memorandum Number L-1998-5 for procedures used to compute interest penalties on judgment claims. If supporting documentation required in item 6i is missing, the lender or holder will be notified by fax or e-mail to submit the missing documentation. If the requested documentation is not received by the HEAL Program within seven calendar days of the date of the notification by e-mail/fax, the claim will be rejected and returned to the lender, or if, in the Secretary=s determination, the documentation supplied does not appropriately support the excessive time in litigation, interest will be deducted from the claim for the time over two years that the loans were in litigation. D. Bankruptcy 1. Chapter 11 & 13 Bankruptcy Claims a. The claim must contain
a Bankruptcy 341 Notice (Notice of Meeting of Creditors) issued by the Bankruptcy
Court. Documents other than the Bankruptcy 341 Notice, if acceptable to the
HEAL Program (e.g., PACER report), may be Atemporarily@ accepted
as proof of bankruptcy filing. When the lender receives the copy of the Bankruptcy
341 Notice, they must send it immediately to the HEAL Program. The amount on the Proof of Claim and the final amount on the Payment History must be within $1,000 of the total amount requested on the HRSA 510 claim form must match. If a variation in the amounts exist, the lender or holder must provide a detailed explanation of how the amount on the Proof of Claim was arrived at from the last entry on the Payment History. d. The claim must contain
an original Transfer of the Proof of Claim. 2. Adversary a. The claim must contain
a Bankruptcy 341 Notice (Notice of Meeting of Creditors) issued by the Bankruptcy
Court. Documents other than the Bankruptcy 341 Notice, if acceptable to the
HEAL Program (e.g., PACER report), may be Atemporarily@ accepted
as proof of bankruptcy filing. When the lender receives the copy of the Bankruptcy
341 Notice, they must send it immediately to the HEAL Program. The amount on the Proof of Claim and the final amount on the Payment History must be within $1,000 of the total amount requested on the HRSA 510 claim form must match. If a variation in the amounts exists, the lender or holder must provide a detailed explanation of how the amount on the Proof of Claim was arrived at from the last entry on the Payment History. d. The lender or holder
is required to answer the Complaint within 30 calendar days of the date of
the Summons. If the lender or holder receives the document in an untimely
manner, the lender or holder must either answer the Complaint or file a Motion
for an extension of time to answer the Complaint. The extension must be granted
in order for the Secretary to accept the claim. (If the lender or holder
provides a documented acceptance of the extension from the debtor=s attorney
with a filed Motion to extend the deadline to answer the complaint, the claim
will be approved.) If the Adversary Bankruptcy Claim is not submitted to the HEAL Program within the 10-day limit allowed, the claim package will be rejected unless, in the Secretary=s opinion sufficient time remains to respond to the court. However, interest will not be paid beyond the 10-day limit. 1. A copy of the HEAL rejection letter (REJECT1 letter) must be included with the re-submission of any individual loan or claim package that has been rejected, in whole or in part, at any time previously. 2. A rejected bankruptcy claim may be re-filed in accordance with the general rules governing the refiling of rejected claims. If a rejected bankruptcy claim is refiled after the close of the 10-day period after initial receipt of the court Notice by the lender or holder, the claim will also be reviewed to determine whether the delay in refiling has prejudiced the Secretary=s ability to collect on the loan. (See HEAL Regulation, section 60.41(d).) HEAL CLAIMS DOCUMENT DESCRIPTION AND DOCUMENT ORDER
Loan account
servicing and payment history,
Deferment
periods, including AAMC residency match, if applicable
Principal and Interest calculation worksheet, '60.40(a)(4) Include all disbursements for loans contained in the claim, interest, compounding, payments, and running balance up to the date of the claim submission. II. Death Claims 11. Death Certificate, '60.39(a) & '60.40(c)(2) Content Requirement Original or certified copy. Claim must be filed within 30 calendar days of the date of the receipt of the death certificate by the lender/holder/servicer. III. Disability Claims 12. Disability Letter, '60.39(b) & '60.40(c)(3) Content Requirement Original letter from DHHS approving borrower for total and permanent disability. Claim must be filed within 30 calendar days of the receipt of DHHS disability letter by the lender/holder/servicer. IV. Default Claims A. LOW BALANCE/LOW LOAN AMOUNT CLAIMS Low Balance Loans, HEAL Policy Memo L-93-2 CONTENT REQUIREMENT Evidenced by supporting documentation where loan balance is below $300. Claim must be submitted within 30 calendar days of the date for the 3rd PCA letter request by the lender/holder/servicer. LOW BALANCE/LOW LOAN AMOUNT CLAIMS Loans <$5,000 made prior to 11/4/88, '60.35(c)(3)(ii) & '60.40(c)(1)(i) CONTENT REQUIREMENT Evidenced by supporting documentation and/or the HEAL database. Claim must be submitted within 30 calendar days of the 3rd PCA letter request by the lender/holder/servicer. LOW BALANCE/LOW LOAN AMOUNT CLAIMS Loans <$2,500 made on or after 11/4/88, '60.35(c)(3)(iii) & '60.40(c)(1)(i) CONTENT REQUIREMENT Evidenced by supporting documentation and/or the HEAL database. Claim must be submitted within 30 calendar days of the 3rd PCA letter request by the lender/holder/servicer. B. SKIP CLAIMS Skips, '60.35(a)(2) CONTENT REQUIREMENT Evidence in collection history of actions taken and dates. Actions must comply with 42 C.F.R. '60.35(a)(2). Claim must be submitted within 30 calendar days of the determination that the borrower is a skip. C. UNABLE TO SERVE CLAIMS Unable to Serve, '60.35(a)(2), '60.35(c)(3), & HEAL Policy Memo L-92-8 CONTENT REQUIREMENT Copy of Complaint and Return of Service documenting attempts to serve, including time, place, and date of attempt(s). Three attempts to serve are required for accounts $10,000 or greater; one attempt for accounts below $10,000. At least one attempt is acceptable if attempted service is conducted by officers of the court (public service).
V. Bankruptcy
USE OF AFFIDAVITS OF LOSS AND INDEMNIFICATION The HEAL program permits the use of affidavits of loss and indemnification in situations in which the lender/holder/servicer, after exercising diligence in its attempts to locate, is unable to locate and submit (a) the original promissory note, (b) the original or a legible copy of one or more deferments, (c) the original or a legible copy of one or more forbearances, or (d) the original or a legible copy of one of the first repayment schedule. Affidavits of loss and indemnification will be permitted to be used in accordance with the following policies. 1. Affidavits of loss and indemnification are intended to be used in exceptional circumstances only. They are not intended to be used in place of proper document retention and retrieval practices or proper claim package preparation. Excessive use, as determined by the Secretary, could result in the elimination of their use. 2. A legible copy of the promissory note must always, in every type of claim, accompany an affidavit of loss of the original note and indemnification. 3. A separate affidavit of loss and indemnification must be submitted for each missing original promissory note or each missing original or legible copy of a deferment request, forbearance request, or first repayment schedule. Multiple missing documents may not be combined or included in one affidavit of loss and indemnification. 4. If a demand for repurchase of a claim is made under an indemnification and the lender does not pay the amount demanded within 45 days of the date of the demand, the Secretary will off-set the amount of the demand against amounts due to the lender for other claims. AFFIDAVIT AND INDEMNITY FOR MISSING DOCUMENT I, , an authorized representative of (hereinafter the Lender or Holder), being duly sworn, state that a (Original Promissory Note; Original or Legible Copy of a Deferment, Forbearance, or Repayment Schedule) (Describe the document specifically, including the date.) for the HEAL claim for , (SSN - - ), is missing despite reasonable attempts made by the Lender or Holder to locate the document. If it is found, the Lender or Holder agrees to provide the missing document to the Department of Health and Human Services (DHHS) as soon as possible. In consideration of the payment by DHHS of the above-described claim, the Lender or Holder agrees to repurchase the loan(s) related to the missing document from DHHS if DHHS is unable to fully collect the amount due on the loan(s) or the judgment related to the loan(s) because of the missing document, as documented in writing by the Assistant United States Attorney to whom the loan(s) or judgment thereon has been assigned for collection. The repurchase price of the loan(s) will be the amount paid to the Lender or Holder for the loan(s) by DHHS pursuant to the Lender=s or Holder=s insurance claim, plus interest at the applicable promissory note or judgment interest rate, plus direct costs of DHHS in its litigation activities incurred relating to the missing document, such as deposition, travel, transcript fees, and any and court-ordered costs.Name: Title: Sworn to before me this day of , 200 , (Notary Public) My Commission expires: Bureau of Health Professions Division of Health Careers Diversity and Development HEAL Program Fax Nos: (301) 443-0795 (301) 594-6911 HEAL CLAIM MISSING DOCUMENT/DEFECT NOTIFICATION Date: To: From: Office: Phone #: 301-443- Fax #: Fax #: ______ 301-443-0795 ___ Phone #: 301-594-6911
YOU SHOULD RECEIVE ONLY THIS ONE-PAGE FAX NOTIFICATION SHEET.
NOTICE: The documents (deficiencies) listed below are missing from (exist) in your claim package for, Borrower=s Name: , SSN: . Please submit the missing document(s) and/or correct the notified deficiencies to the HEAL Program within 7 calendar days of the date of this notification. If the requested document(s) is not received by the HEAL Program within 7 calendar days of the date of this notification, the claim package will be placed in a REJECT1 (R1) status and returned. Missing document(s): Defect(s): Confidentiality Notice This facsimile transmission contains confidential and/or legally privileged information from the HEAL Program intended only for the use of the individual named on this transmission sheet. If you are not the intended recipient, you are hereby notified that any disclosure, copying, or distribution of this information or the taking of any action in reliance of the contents of this facsimile transmission is strictly prohibited. If you have received this transmission in error, please notify the sender by telephone immediately. Bureau of Health Professions Date Contact Name Holder Name Holder Address xxxxxxxxxxxxxxxx Re: Borrower Name SSN: xxx-xx-xxxx Claim Amount: $xxxxxxxx Claim ID: xxxxCxxxxxxx Claim Type: xxxxxxxxxxxxxxx Dear Contact Name: We are returning the rejected claim that was received by the Health Education Assistance Loan (HEAL) Branch for payment on (date) . The claim was rejected for the following reasons. 1. The claim package was missing more than one document and therefore is rejected. The following documents were missing in the claims package: _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ 2. The loan servicing history did not reflect the required activity: _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ 3. Other reasons: _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ Prior to the refiling of a rejected claim, please review the HEAL general rules on refiling rejected claims and penalties/cures for defects in servicing accounts. Rejected claims (R1 status) may be refiled only one time. The Department will reject (R2 status), without further review, any claim that is filed after a second rejection or any loan filed with a rejected claim (R2 status). PLEASE TAKE SPECIAL NOTE: The refiling of a rejected claim must occur within 60 days of the date shown on this rejection letter. Interest will be paid only for the first 30 days after rejection. After the 60-day period has expired, the claim may not be refiled. If you have any question, please contact HEAL reviewer=s name of the HEAL Branch at (301) 443-1540. Sincerely, Henry Lopez, Jr. Enclosure Bureau of Health Professions Date Contact Name Holder Name Holder Address xxxxxxxxxxxxxxxx Re: Borrower Name SSN: xxx-xx-xxxx Claim Amount: $xxxxxxxx Claim ID: xxxxCxxxxxxx Claim Type: xxxxxxxxxxxxxx Dear Contact Name: In accordance with Health Education Assistance Loan (HEAL) Lender Policy Memorandum L-2003-1, dated November 14, 2003, the HEAL Program has rejected the above claim and placed it in a REJECT2 (R2) status. This status is a final rejection of the claim and all HEAL loans associated with the claim become permanently uninsured. This claim is being returned to you together with a copy of the REJECT1 (R1) letter issued on (date) . Your institution was allowed to correct the errors referenced in that letter and submit a corrected claim package within 60 days (interest to be paid for the first 30 days). Corrections to the above referenced claim were either insufficient or not performed within the 60-day deadline submission. Because the 60-day deadline his expired, the following HEAL loans will be permanently uninsured: Loan ID Original Principal Amt. Disbursement Date Holder ID Servicer ID A lender/holder/servicer may appeal this decision if you believe that review by the HEAL Program of the re-submitted claim was flawed. You must appeal to the Director, Division of Health Careers Diversity and Development to re-consider the decision of the HEAL Program. Such an appeal can be made only once and must be made within 30 calendar days of the date of this FINAL REJECT2 (R2) letter rejecting the re-submitted claim. The letter of appeal must include the following: 1) the HEAL Program letter notifying the lender/holder/servicer the rejection of the original claim; 2) the re-submitted claim; 3) this letter and enclosure; and 4) the reasons as to why, in the opinion of the lender/holder/servicer, the review of the re-submitted claim by the HEAL Program was flawed. If you have any questions, please contact Ms. Nancy Durham, Acting Chief, HEAL Branch at (301) 443-1540. Sincerely, Henry Lopez, Jr. Enclosures Claims may contain multiple loans. Regardless of the number of loans included in a claim, the claim is reviewed as a whole. When a claim is denied for payment (REJECT1 status), lenders may re-submit the claim, in some cases subtracting one or more problem loans. Re-filing of a rejected claim is governed by the policy as specified in the section on Re-submission of the Rejected Claims in this document. 1. All loans ready for filing for a particular borrower (i) that are included in a bankruptcy filing or in a judgment order, (ii) the loans that are in default and have been through the litigation process without concluding in a judgment (skips and unable to serves), or (iii) the loans that exist at the time of death or disability of the borrower must be filed at the same time, all together, in one claim. 2. If a claim is rejected (REJECT1 status), one or more problem loans may be subtracted from a re-filed claim and the subtracted loans may be refiled separately. 3. For claims based on judgments: If fewer than the total number of loans included in the judgment order are included in a claim that is re-filed after rejection (REJECT1 status), the re-filed claim must include a statement indicating what portion of the judgment applies to each of the loans included in the re-filed claim. The lender/holder/servicer may re-file a claim for loans included in the original judgment but not previously paid without obtaining a new judgment if the previously identified deficiencies are corrected and the portion of the judgment applicable to the loans included in the re-filed claim is clearly specified. 4. Previously unfiled loans that become ready for filing after the filing of the initial claim may not be added to a refiling of a rejected (REJECT1 status) claim. If these loans were not included in the package, an explanation must be provided as to why they were excluded. Such loans must be filed in a separate claim in accordance with paragraph 1 above. 5. Interest will be paid only for the first 30 calendar days from the date of the letter notifying the rejection of the original claim. RE-SUBMISSION OF THE REJECTED CLAIMS 1. A rejected claim (R1 status) can be re-submitted for payment only once and must (i) include a copy of the HEAL Program letter notifying them of the rejection of the original claim, (ii) include the missing documents, and (iii) correct the loan servicing deficiencies, if any, and/or provide requested information/explanations to the satisfaction of the HEAL Program. 2. A rejected claim (R1 status) must be received by the HEAL Program within 60 calendar days from the date of the HEAL Program letter notifying them of the rejection of the original claim. The payment for a claim re-submitted beyond this 60-day limit will be denied, hence rejected (R2 status), and the claim will be returned to the lender/holder/servicer without review. 3. However, if, in the opinion of the lender/holder/servicer, the review by the HEAL Program of the re-submitted claim was flawed, they can appeal to the Director, Division of Health Careers Diversity and Development, to re-consider the decision of the HEAL Program. Such an appeal can be made only once and must be made within 30 calendar days of the date of the HEAL Program letter notifying them of the rejection of the re-submitted claim. The letter of appeal must include the HEAL Program letter notifying the lender/holder/servicer the rejection of the original as well as the re-submitted claim and must also include the reasons as to why, in the opinion of the lender/holder/servicer, the review of the re-submitted claim by the HEAL Program was flawed. DEFECTS IN ACCOUNT SERVICING AND CLAIMS The Secretary does not pay claims if the lender/holder/servicer has not complied with the HEAL statute and regulations. Section 60.41(d) of the HEAL regulations, however, grants the Secretary discretion to permit waiver or cure of certain defects as a condition for payment if, in the Secretary=s determination, the defect did not contribute to the default or prejudice the Secretary=s attempt to collect the loan(s) from the borrower. In exercise of this discretion, the Secretary has determined that: (a) There may be defects that arise in exceptional circumstances that fit within section 60.41(d) for which the Secretary will allow waiver or cure by the lender or holder. So that the HEAL Program may make a decision pursuant to the requisites of section 60.41(d), a written statement addressing the criteria for waiver or cure of the defect contained therein, so far as they apply to the defect(s) in the claim package, must be submitted with the claim package. This statement must be complete and must address (1) a description of the defect and how it occurred, (2) why the defect did not contribute to the default, and (3) why the defect will not prejudice the Secretary=s attempts to collect the loan(s) from the borrower. The lender or holder must include this statement with the first submission of the claim. (b) There are defects that are serious enough that the Secretary will not exercise discretion under section 60.41(d) and will not pay claims involving such defects. (c) There are defects that might otherwise result in rejection of a claim but for which the Secretary, rather than reject the claim outright, will impose an interest penalty and pay the claim minus the amount of the penalty, so long as the defect does not prejudice the Secretary=s ability to collect the loan(s). Such defects, as determined at the present time, are set forth below. 1. Death claims must be filed within 30 calendar days of the date of receipt of the death certificate by the lender/holder/servicer. Penalty: Disallow interest after the 30-day period. 2. Disability claims must be submitted within 30 calendar days of the date of the receipt of the disability letter from the Department of Health and Human Services. Penalty: Disallow interest after the 30-day period. 3. Claims based on loans of less than $5000 made prior to 11/1/88, loans of less than $2500 made after 11/1/88, and low balances (under $300) must be filed within 30 calendar days of the date of the request for the third PCA letter. Penalty: Disallow interest after the 30-day period. 4. Deferment periods by type. Penalty: Disallow any interest if over the number of months/years allowed in legislation/ regulations for the specific deferment type. 5. Claims based on skips must be filed within 30 calendar days of the date of the determination that the borrower was a skip. Penalty: Disallow interest after the 30-day period. 6. Unable to serve claims must be filed within 30 calendar days of the date of the final attempt to serve (number of times the service must be attempted depends on amount of the account and whether service attempts were made by private or public agency). See Lender Policy Memorandum L-92-8. Penalty: Disallow interest after the 30-day period. 7. Claims based on judgments must be filed within 60 calendar days of the date of the judgment or alternatively (HEAL Policy Memorandum L-1998-5) within 60 calendar days of the receipt of the certified copy of the judgment by the lender/holder/servicer and within 30 calendar days of the date of the receipt of certified copy of the judgment by the lender/holder/servicer. Penalty: Disallow interest after the 60-day or 60-day/30-day period as applicable. Additionally, interest will be paid only if the certified copy of the judgment was received within 60 calendar days of the date it was issued and if the claim was filed within 30 calendar days of its receipt by the lender/holder/servicer. If a certified copy of the judgment was not received within 60 calendar days of the date it was issued, interest will be paid for that time between the initial 60-day period and the date of receipt only if documentation is submitted with the claim showing that written follow up was performed every 15 calendar days beginning on the 60th day to obtain a certified copy of the judgment. 8. Claims based on any type of bankruptcy (Adversary or Chapters 11 or 13) must be filed within 10 calendar days of the date of the receipt of first notice of bankruptcy. Such notice may be a Summons and Complaint, 341 Notice, or other notice from the borrower=s representative, as appropriate. Penalty: Disallow any interest after the 10-day period and possibly reject the claim entirely if the government=s ability to defend the matter has been prejudiced by the delay. 9. Interest Penalties for Gaps in Servicing: Note: The following presume that the specified action or activity was, in fact, performed, but was done beyond the time period required. If the action was not performed at all or at an inappropriate time, that action/inaction will cause interest penalties to be assessed on the claim. a. Failure to report delinquency to credit bureau at 60 days delinquency; b. Failure to request PCA letters at 90, 120, and 150 days delinquency; c. Failure to begin litigation activity between day 150 and day 180 of the date of delinquency; Penalty: Interest will be deducted from claims for any days in excess of the time periods listed in a-c above until the day the activity was actually taken. d. Failure to contact the borrower in writing at least 30, but not more than 60 calendar days before repayment is to begin. Penalty: Unless the borrower makes a payment within the period in which repayment was to begin, interest will be deducted from claims for the time period between 30 days prior to entering repayment and the date of actual contact with the borrower, as evidenced in the loan servicing history. Lenders and holders should note that pursuant to section 60.34(b)(1) of the HEAL regulations, lenders may not charge borrowers for the additional interest or other charges, penalties, or fees that accrue when a lender does not contact the borrower within this time period and a late conversion results. e. Excessive time in litigation. The Secretary will review carefully any accounts that have been in litigation, particularly those which have been in litigation for over two years, to assess whether the litigation activity was continuous or whether it appears that insufficient attention was paid to the litigation activity for any periods of time. Penalty: Interest will be deducted from the claim for any time over two years that the account was in litigation, unless the lender documents that constructive legal activity on the account was ongoing and continuous during the entire time. f. Gaps in servicing, i.e., failure to take required actions to collect the loan(s) within the required time periods set forth in the regulations when an account becomes delinquent. Penalty: Interest will be deducted from the claim for any period of time between the date when a certain collection action was required to be taken on a delinquent account and the date when the action was taken or the borrower started making payments again. These collection/due diligence actions are set forth in HEAL regulations section 60.35. 1. Forbearance in excess of 24 or 36 months without HHS approval letter for that time period. Penalty: Interest will be deducted for days that exceed the 24/36 months maximum that did not have HHS approval. 10. Securing a judgment may suffice to cure a good faith omission of a due diligence requirement contained in section 60.35 of the HEAL regulations, provided that, in accordance with section 60.41(d), the omission does not prejudice the Secretary's ability to collect the loan. The securing of a judgment will not, however, negate the imposition of any of the above-stated penalties, which will be assessed in all cases against all claims that include any of the due diligence/collection defects, errors, or omissions set forth herein. 11 All loans for which litigation was initiated at any time in the servicing history will be cross-checked against the HEAL litigation database. If the account entered litigation at any time, the loan(s) must have been reported to the HEAL Program on the litigation tape for the month the account entered litigation. This requirement will be effective the date the lender/holder/servicer was required to report litigation data to the Secretary. Penalty: If the account or any of the loans included in the claim do not appear in the HEAL litigation database, the claim will be rejected (Reject1). Appropriate action may be taken by the lender to include the litigation information on the next litigation tape (either the next monthly submission or a special separate submission due to timing constraints associated with refiling a rejected claim. The lender may then re-file the claim, within the time permitted for refiling as stated in item 11 below and in Section ARe-submission of Rejected Claims@ in this document, but interest will be deducted for the period of time between the date litigation was begun and the date the litigation was reported to the HEAL Program. 12. A rejected claim must be re-filed within 60 calendar days of the date of the rejection, if it is to be refiled at all. Particular loans that have been excerpted from a previously rejected claim also must be refiled within 60 calendar days of the previous rejection, if they are to be refiled at all. Penalty: (a) Interest will be paid only for up to 30 calendar days from the date of the initial rejection. (b) After 60 days from the date of initial rejection, previously rejected claims, or loans included in previously rejected claims, will not be allowed to be re-filed. HEAL SYSTEM EDITS FOR CLAIMS PROCESSING
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