continuous quality improvement (CQI)

Process that continually monitors program performance. When a quality problem is identified, CQI develops a revised approach to that problem and monitors implementation and success of the revised approach. The process includes involvement at all stages by all organizations, which are affected by the problem and/or involved in implementing the revised approach. Sometimes called total quality management (TQM) and quality improvement (QI).

Continuous service

When a member leaves his occupational pension scheme but keeps his benefits in the fund, and subsequently resumes membership, the periods of service before and after the break may be aggregated. Aggregation also occurs when an employee moves from one employer to another employer in the same scheme.

Continuum of care

Medical care of all levels and intensity such as skilled nursing care and intermediate care provided to frail and chronically ill patients in a variety of settings (e.g., hospital facilities, nursing homes) over an extended period of time. Services also focus on the social, residential, rehabilitative, and supportive needs of individuals. Also see episode of care (EOC).

Contra proferentem rule

Any ambiguity in the wording of a contract will be construed against the person who drew up the wording, i.e. in insurance against the insurer. The rule will only be applied where there is real ambiguity.
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In any unilateral contract, such as an insurance policy, any ambiguity in the language of the contract is strictly interpreted against the party that wrote the contractin this case, the insurance company. This is known as the contra proferentem rule and it involves a three-step process.First, the court examines the language in the policy to determine whether or not it is clear and unambiguous. Second, if the court decides the language is ambiguous, evidence is admitted in an attempt to determine the true meaning of the language. This can include, for example, testimony of the parties to the contract about their original intent. If the additional evidence does not clarify the policy’s language, then the contra proferentem rule is applied and the ambiguous language is interpreted in favor of the party bringing suit against the insurance company. (See Unilateral Contract).