Delayed payment clause (Life Insurance)

A clause within life insurance, stating that payout of benefits to the beneficiary will be delayed for a set amount of time after the insured’s death. If the primary beneficiary is deceased at the end of this time period, the benefits will be paid to contingent beneficiaries or the deceased’s estate. This clause is often used in the case of a common disaster where the insured and the beneficiary are both killed.

Delayed turnover

Postponed trade that a business interruption insurer is entitled to take into account when adjusting a claim. After trading is resumed, turnover may rise above the normal level due to postponed orders coming good. Provided this occurs within the maximum indemnity period the insurer can make due allowance in his calculation of the reduction in turnover. This adjustment is also called ‘clawback’.

Delegable duties

Where a principal delegates work to an independent contractor, and his duty in respect of that work is no higher than a duty to take reasonable care, his duties are ‘delegable’ and he discharges them by taking care to select a competent contractor. Certain duties are ‘non-delegable’.

Delegated official

Individual who is given legal authority by an authorized official of the provider to make changes to the organization’s status in the Medicare program (e.g., change of address or new location for the practice) or to notify the provider to follow the regulations and Medicare program guidelines.

Deleted claim

Insurance claim that has been canceled, deleted, or voided by a Medicare fiscal intermediary for the following reasons: CMS-1500 (08-05) or current CMS-1450 is not used, itemized charges are not provided, more than six line items are submitted on the CMS-1500 (08-05) claim form, patient’s address is missing, internal clerical error was made, Certificate of Medical Necessity (CMN) was not with the Part B claim or was incomplete or invalid, and name of the store is not on the receipt that includes the price of the item.

Deliberate concealment

1. The deliberate concealment of a material fact by a proposer is a fraudulent breach of the utmost good faith. 2. Limitation Act 1980, s.2, defines the term as ‘the deliberate commission of a breach of duty in circumstances in which it is unlikely to be discovered for some time. The six-year limitation period runs from time of discovery of deliberate concealment with no long-stop provision. Professional negligence errors could go undiscovered for years, but the House of Lords rejected the view that an act of negligence could amount to deliberate concealment (Cave v. Robinson Jarvis & Rolf (2002)). A contrary decision would have meant open-ended liability for negligent professionals.