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Adhesive Contract

An adhesive contract is one that is written and issued by one party to the contract and does not require the signature of the other party to the contract to be valid. Insurance contracts are adhesive contracts since the contract is written and issued by the insurance company and the insured is not required to sign the policy. If a dispute arises concerning the terms of the contract, courts will generally interpret the contract conditions in favor of the party that did not write the contract -in this case, the insured. (See Unilateral Contract).

Adhikari Suraksha Kavach (Executives All Risks/Businessman’s All Risks)

A personal package policy designed for executives and/or businessman. Policy covers (I) Laptop/portable computer due to any unforeseen loss or damage due to any cause whilst anywhere in the world, subject to an excess. (II) Cellular Phone: Loss and/or damage including theft, burglary, malicious or accidental damage (III) Loss of Cash: Loss of cash due to accident or misfortune when the insured is on official duty or on outstation tour subject to a maximum per event limit (IV) Baggage Insurance: Loss or damage to baggage due to accident or misfortune whilst on journey anywhere in the world (V) All Risks for Jewellery and Valuables (VI) Personal Accident (VII) Health Insurance (VIII) Personal Liability.

Adjacent

Living near to, but not in actual contact with nearby property. Some Insurance policies cover adjoining but not adjacent property. Refer “Adjoining.”

Adjoining

In physical contact with, rather than next to, but not touching. One building is adjacent to another when it is so located that it touches the other building. Contrast with “Adjacent.”

Adjudicate

Processing of an insurance claim by an insurance company through a series of edits for determination of coverage (benefits) and issue of payment to the provider or patient.

Adjudication

A quasi-arbitration where a neutral adjudicator issues an award or decision, binding on the parties, unless unenforceable by the court or an arbitrator. The Housing, Grants, Construction and Regeneration Act 1996 provides a compulsory adjudication scheme in most construction contracts to resolve disputes on an interim basis, to minimise site delays. The adjudicator reaches a decision within 28 days of referral. The decision is binding unless the dispute is finally decided by agreement, or until, on occasions only, there is a fresh hearing by litigation or arbitration. Otherwise the court intervenes if the losing party refuses to honour the adjudicator’s decision. See ALTERNATIVE DISPUTE RESOLUTION.
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MEDICAL, US:

Process of the final determination of the issues involving settlement of an insurance claim as payable, partially payable, or denied; also known as claim settlement

Adjunct codes

CPT codes that are referred to in the Medicine Section as Special Services, Procedures and Reports and fall under the category of Miscellaneous Services. They are important to consider when billing because these codes provide the reporting physician with a means of identifying special services and reports that are provided in addition to the basic services provided such as handling of laboratory specimens, telephone calls, seeing patients after hours, office emergency services, supplies and materials, special reports, travel, and educational services rendered to patients.

Adjunctive dental care

This type of dental care includes dental and oral tissue examination and diagnosis at the request of a physician (MD). It is provided after the physician’s examination and is done to help improve the systemic condition of the whole body and not just one area.

Adjustable feature

A cost modification provision found in some reinsurance agreements. Parties agree to adjust final premium rate or final ceding commissions retrospectively, in accordance with the loss experience, by formulas set forth in the agreement.