1. An admission by an insurer or reinsurer that they are liable for a claim under their contract. 2. An admission by an insured that he is liable for injury or damage caused to a third party. In a liability policy the insurer’s conduct of proceedings clause and non-admission of liability clause prevent the insured from negotiating with the claimant or admitting liability without the insurer’s consent. The clauses are conditions precedent to liability.
Insurance Encyclopedia
Admission process
Registration of a patient either as an inpatient or outpatient for receiving medical services in a health care facility. Admissions staff give the patient a registration number and obtain demographic, insurance, and medical information, which is entered into the computer system.
Admission review
Review a patient’s medical case for appropriateness and necessity of admissions.
Admission wire
Blue Cross and Blue Shield phrase; a formal notice sent by a host plan to the home plan that one of their members has been admitted into a plan hospital in the host plan’s area and a request for membership information. See also approval wire.
Admission/1000
The number of hospital admissions for each 1000 members of the health plan.
Admissions per 1000 (APT)
Method used to compare the number of hospital admissions for defined populations for a specific period of time, usually 1 year. APT is commonly used by managed care plans to evaluate utilization management performance. Admissions per 1000 formula: number of hospital admissions for a population divided (÷) by the number of persons in that population, and the result multiplied (×) by 1000.
Admits
The number of admissions to a hospital (including outpatient and inpatient facilities).
Admitted (Authorized) Reinsurance
Reinsurance for which credit is given in the ceding company’s Annual Statement because the reinsurer is licensed or otherwise authorized to transact business in the jurisdiction of domicile of the ceding company. (See also Non-Admitted Reinsurance)
Admitted Assets
Those assets of an insurer that under IRDA guidelines can be taken into account in representing the financial position of the company.
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Cash and investments that meet criteria for liquidity and safety set by the National Association of Insurance Commissioners (NAIC) and by individual state commissioners. Only admitted assets are used in measuring the capacity and soundness of an insurer. Nonadmitted assets, such as overdue receivables, are excluded from statutory assets and surplus.
Admitted Company
A company licensed to provide insurance in a particular state.
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US: A company licensed or authorized to sell insurance to the general public. In the United States, admitted companies are licensed on a state-by-state basis and differentiated from surplus lines insurers, which are authorized to sell insurance in a state on a nonadmitted basis.
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An insurance company that is licensed (admitted) to conduct business within a given state.
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