These fees are covered when relating to insured property damage either by making due allowance in the sum insured or by a special item. The fees are payable for plans, specifications, etc., and general supervision of rebuilding in the event of fire or other insured perils. Increasing the buildings sum insured by 12.5 per cent and the machinery sum insured by 7.5 per cent often provides cover, but insureds with very large sums insured may insure the fees on a first loss basis. Fees paid by the insured for preparing the claim are not covered.
Insurance Encyclopedia
Area Agency on Aging (AAA)
Local (city or county) organization, funded under the federal Older Americans Act, that plans and coordinates various social and health service programs for persons 60 years of age or more. These needs include adult day care, skilled nursing care/therapy, transportation, personal care, respite care, and meals. The network of AAA offices consists of more than 600 approved agencies.
Area Ignition
Simultaneous or rapid successive ignition of a number of individual fires that are spaced to support each other and spread the fire quickly.
Area of Origin
In fire investigation parlance, the place where a fire started.
ARGUS
Software program created by the Office of the Inspector General (OIG) that helps to access provider claims data and to limit the need for the OIG to send multiple requests to insurance carriers for claims information. It can assist in detection of aberrant billing practices of providers.
ARHCP
See: Association of Registered Health Care Professionals (ARHCP).
Arise out of employment and in the course of employment (AOE/COE)
In workers’ compensation cases, a criterion for determining liability, or whether a claim is or is not compensable. AOE refers to how the activity of work led to the injury in question. It is one of the legal tests that must be met for a medical condition to be covered by workers’ compensation insurance. COE refers to how the activity the employee was engaged in at the time of injury must grow out, or be incidental to, the employment.
Arising Out of Employment
Refer: “Accident, arising out of and in the course of employment.”
Arithmetic mean length of stay (AMLOS)
In the Medicare program, the average number of days for a patient’s DRG inpatient hospital stay. This figure is used to determine payment for outlier cases and to predict occupancy rates. To obtain this number, use this formula: total number of patient days divided by (÷) the total number of hospital admissions for a specific time period. It is also known as average length of stay (ALOS).
Armed services disability
Disability occurring or aggravated while the patient is in military service.